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Why are pregnant women given immunoglobulin? Normal human immunoglobulin: instructions, reviews, price

If a pregnant woman has a negative blood type, and the baby inherits the father's positive Rh, there is a risk of Rh conflict. The mother's immune system regards the fetus as a foreign body and tries to reject it. The risk of a conflict between the Rhesus of the mother and baby increases by 10% with each pregnancy. With such initial data, women are often offered an injection of immunoglobulin. For what indications is the drug needed and how many injections are needed?

What is the purpose of immunoglobulin and how does it work?

Immunoglobulin is a drug that is a protein fraction and consists of antibodies extracted from the blood plasma of donors. There are two types of medication:

Human immunoglobulin. Used when a person is faced with an infectious disease (herpes, cytomegalovirus, etc.). The drug is used extremely rarely for pregnant women - it is necessary if the expectant mother’s body does not respond to antibacterial agents or she is at risk of miscarriage. The purpose of using the medication is to stimulate the immune system. A few days after immunization, a woman becomes resistant to infections.
Anti-Rhesus. The drug is injected into pregnant women when a conflict arises between the Rh blood levels of the mother and child.

Anti-Rhesus immunoglobulin (anti-D) differs from normal human immunoglobulin in that it includes antibodies to Rh-positive antigens, rather than to viruses. People without medical training often mistake it for a vaccination, comparing it with vaccines, for example, against the flu or chickenpox. However, the differences are fundamental: the medication contains antibodies synthesized by the immune system, and not inactivated pathogens.

When an anti-Rhesus drug is administered to a mother, the antibodies contained in it replace immune cells, thereby “deceiving” the defenses of her body. Positive red blood cells that enter the bloodstream from the baby are destroyed, which prevents an immune response and termination of pregnancy. Timely use of the drug ensures the normal course of pregnancy and significantly reduces the possibility of hemolytic disease in the second child and subsequent children.

Indications for the use of immunoglobulin during pregnancy

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Before using immunoglobulin, the doctor must weigh the pros and cons, since this is a strong immunostimulating drug, the effect of which on the child developing in the womb has not been fully studied. It is used exclusively for negative Rhesus in women.
Direct indications for the use of serum are:
opposite rhesus indicator in the fetus;
risk of miscarriage;
high risk of Rh conflict;
diabetes;
violation of the placental barrier;
placental abruption;
peritoneal injuries;
late toxicosis in severe form;
ectopic pregnancy;
“positive” blood from the father;
abortion;
infectious diseases.

Contraindications and side effects
The drug is not prescribed in a number of cases:
hypersensitivity to the drug;
severe allergy to any blood products;
Rh negative with sensitization and the presence of antibodies;
Rh positive.

Immunoglobulin should be used with caution during pregnancy if the expectant mother suffers from migraines or kidney disease. The medication cannot be combined with some medications, so a separate syringe or dropper is needed to administer it.
If during injection or infusion into a vein the dosage and rate of delivery of the medicine are observed, there will be no serious side effects. Within an hour the following are observed:
malaise;
headache;
chills;
slight increase in temperature.

Immunoglobulin is normally tolerated by patients, but sometimes a woman may be bothered by:
cough;
nausea and vomiting;
dyspnea;
hyperthermia at the site of needle insertion;
excessive salivation and sweating;
chest and stomach pain;
allergy;
weakness;
aching joints, like flu;
facial hyperemia.

Methods of using immunoglobulin
Immunoglobulin is administered twice: at 28 weeks of pregnancy and immediately after birth. This helps prevent the occurrence of a conflict between the Rhesus of the mother and the baby when the woman becomes pregnant again. The drug is administered intramuscularly and by intravenous infusion. The method of application is determined by the dosage, the state of immunity, as well as how the body of the expectant mother tolerates this substance.
During pregnancy
The drug is administered after the expectant mother has passed a test for antibodies to the D-antigen. If she is at risk of miscarriage, the doctor gives an injection of immunoglobulin in a standard dosage at the 7th month of pregnancy, and a second infusion will be needed after childbirth. The drug remains active in the body for 3 months. Sometimes the timing of the procedure is significantly shifted:
In the 1st trimester, an injection is given if there is a risk of miscarriage or forced abortion.
In case of peritoneal injury at 13–18 weeks or amniocentesis, premature birth, hemorrhage or hematoma formation are possible, therefore the use of the drug is indicated. It is re-prescribed at 26–28 weeks. In case of extensive hematoma, the medicine is administered monthly until delivery.

Before using the drug, warm it for 2 hours at a temperature of 18–20°C. For injection, select a large muscle (buttock, shoulder), where the serum is slowly injected with a special syringe tube. After the procedure, the patient should be under the supervision of doctors for about an hour so that they can assess her body’s reaction to the medication.
After childbirth
Before giving birth, the woman is warned that repeated use of the drug may be necessary. The indication for the procedure is positive Rh in the born child. Otherwise, there is no need for the medicine.
It is recommended to administer the medication within 72 hours after birth, preferably as early as possible. If a test was carried out in the delivery room and antigens were detected in the child, the injection is given immediately. During the first gestation, the risk of Rh conflict is lower, and during the second and all subsequent gestations, it is higher, so the use of the medication makes it possible to avoid complications in the future. Immunoglobulin is also administered after an ectopic pregnancy, its artificial termination, miscarriage, death of a child during childbirth, and placental abruption during a difficult delivery.
The dosage is adjusted depending on how many “foreign” red blood cells (baby’s blood cells) enter the mother’s bloodstream. The standard dose (200–300 mcg) is increased by 1.5–2 times during cesarean section or manual placental abruption.

If the medicine was not administered, then three days later the woman must be tested for antibodies. Their presence can negatively affect the baby, as a result of which doctors will recommend switching him from breast milk to formula.
Consequences for the expectant mother
Immunoglobulin has been used to support the condition of women with complicated pregnancies since 1968, and so far there have been no cases of severe reactions to the drug. However, its use still has possible negative consequences:
Side effects such as skin redness and hyperemia appear infrequently and disappear within 24 hours. A serious consequence of the administration of the drug is anaphylactic shock, but such cases are recorded extremely rarely. If an acute allergic reaction occurs, doctors will immediately provide first aid.
Infection with difficult to treat or incurable infections. The use of extracts from donor blood carries the risk of hepatitis or HIV viruses entering a woman’s body. However, the manufacturers of the drug claim that before its creation, donors are carefully checked, and the serum undergoes multi-stage purification, which practically eliminates all risks. The possibility of infection is 1:10000.
Possibility of overdose. If you follow the manufacturer's instructions regarding calculating the amount of the drug, there are no risks for a pregnant woman. When 15 ml of “foreign” red blood cells enter a woman’s blood, 300 mcg of medication is injected. Experts determine the dosage using the Kleihauer and Bethke method of counting the number of red blood cells.

Prevention of Rhesus conflict
If a woman with negative Rh is planning a pregnancy in advance, she needs to ask the father of the unborn baby to undergo an examination to prevent complications during pregnancy. If she becomes pregnant, you must:
register with a gynecologist before 12 weeks;
administer immunoglobulin at the time prescribed by the specialist if the father’s blood is “positive”;
in the absence of sensitization, use the drug during all pregnancies.

Women with a negative blood type should be careful: if possible, avoid invasive procedures and not have abortions. Immunoglobulin will have to be administered both during natural termination of pregnancy and during abortion. Even if a pregnant woman is given immunoglobulin, the doctor will give her a monthly referral to test for antibodies in the blood.

Immunoglobulin is the only drug that is extremely necessary in some cases during pregnancy. When is it used and what are the risks?

What is immunoglobulin

A special drug that significantly increases the level of the body’s natural defenses is called immunoglobulin. Synthesized from donor blood plasma. There is human immunoglobulin and one obtained from animal blood.
During pregnancy, the level of immunity naturally decreases, this happens in order to preserve the fetus. Otherwise, the immune system will get rid of it. There are times when it is still necessary for a pregnant woman to administer this drug.

Indications for the administration of immunoglobulin during pregnancy

Immunoglobulin is used during pregnancy in the following cases:

Very weak immunity.
Serious abdominal injury.
After analyzing the amniotic fluid.
There is a risk of miscarriage.
Cause fetal rejection.
Terminate ectopic conception.
When the mother's blood enters the baby's circulatory system.

A decision is also made to administer immunoglobulin to a pregnant woman if an infection dangerous to the baby enters her body.

How and when is it administered?

There are several types of the drug - human normal and anti-d. They are administered only in extreme cases under the strict supervision of a doctor. They are used if it is necessary to increase the mother’s body’s resistance to various infections or in order to extinguish the Rh conflict.
Usually, during the first pregnancy, if the fetus and mother have different Rh factors, immunoglobulin is not required. The conflict does not have time to fully form. To maintain subsequent pregnancies, this drug must be administered.
Immunoglobulin enters the body of a pregnant woman through intravenous injections. The drug must be administered slowly and the patient must subsequently be observed in a hospital setting.

Possible consequences after administration of the drug and contraindications

Immunoglobulin is usually tolerated without any problems. Sometimes you may experience:

Brief fever.
Fever.
Headache.
Muscle weakness.
Joint pain.
Increased sleepiness.
Increased heart rate.

The drug is administered in a hospital setting to quickly respond to side effects.
An absolute contraindication to the use of immunoglobulin is an allergic reaction. It can sometimes be very strong, up to anaphylactic shock. It is recommended to use this drug with extreme caution in cases of diabetes mellitus, kidney and heart pathologies.

Use for Rhesus conflict

For the fetus in the womb, Rh conflict poses a real threat. Maternal blood antibodies pass through the placenta into the small organism of the fetus and begin to destroy it from the inside. First of all, the liver, spleen and brain of the unborn baby suffer. Oxygen starvation begins, which can lead to the development of various pathologies or death of brain cells.
Also, destroyed fetal red blood cells release a lot of bilirubin into the blood, which subsequently causes cerebral palsy or physiological jaundice. And that is not all. Under the influence of Rh conflict, excess fluid accumulates in the abdomen, brain, heart, and lungs of the unborn baby, which prevents these organs from fully developing and functioning.
The only remedy that can stop Rhesus conflict is immunoglobulin. Its effect has not been 100% studied to date, but undeniable advantages have been noted.
Before using a drug for Rhesus conflict, the doctor weighs the pros and cons and analyzes the possible risks.

Measures to prevent Rhesus conflict

The ideal match for an Rh-negative woman can only be an identical man, but in life it’s unlikely that you’ll be able to figure it out on purpose, and there’s no point in trying. In order not to risk your health and the health of your unborn child once again, you need to take precautionary measures against the negative consequences of Rh conflict:

If the expectant mother knows about her Rh factor, then it is necessary to donate blood every month of pregnancy to determine antibodies. In their absence, the baby is not in danger. However, all pregnant women with a Rh-negative factor at 28 and 34 weeks of gestation are required to administer an immunoglobulin drug for reinsurance.
A positive test for the presence of antibodies on an alarming scale should alert doctors and the expectant mother. In such cases, the pregnant woman must be hospitalized to preserve the pregnancy and the health of the unborn child.
If throughout the pregnancy of an Rh-negative woman, tests have not shown the presence of an Rh conflict, then after birth, no later than 72 hours, immunoglobulin is administered to prevent fetal rejection in subsequent conceptions.
The same is done when giving a blood transfusion to an Rh-negative woman from a positive donor.

There is no need to be afraid of Rh conflict; it happens as often as any other complication. The main thing is to take proactive measures in a timely manner. In addition, not everything has been studied in this area - a blood conflict does not always occur in a couple with different Rh factors when carrying a child.

If a pregnant woman has an Rh-negative blood type, and the father of the unborn child is positive, and the fetus inherits his Rh factor, an Rh conflict may occur. To exclude the development of complications against this background, the woman is given immunoglobulin during pregnancy.

This measure helps reduce the risk of hemolytic disease of the newborn. In addition, it provides the necessary protection during subsequent pregnancies and reduces the risk of Rh conflict between mother and fetus.

During the first pregnancy, conflict rarely arises, since antibodies work like allergens when they first begin to be produced. Then they accumulate and with each subsequent pregnancy the antibody titer increases, which leads to the destruction of red blood cells in the fetus. All this leads to hemolytic disease, which is accompanied.

To prevent Rh conflict during pregnancy, anti-Rhesus immunoglobulin is used.

Anti-D immunoglobulin is the active protein fraction of human plasma. Contains IgG with incomplete anti-Rho(D) antibodies. The drug reaches its maximum concentration one day after administration.

If the mother has negative blood and the father has positive blood, it is necessary to register with the antenatal clinic before 12 weeks of pregnancy, when the first tests are done, so you need to ask the doctor about the need to administer immunoglobulin while planning pregnancy.

Subsequently, the antibody titer is determined once every 28 days if their content is negative. After the 30th week of pregnancy, antibodies are determined once every 14 days, and after the 36th week - once every 7 days.

Administration of the drug after childbirth is necessary to reduce the formation of antibodies during repeated pregnancies.

There is no need to administer immunoglobulin G during pregnancy and after childbirth if the child's father has a Rh-negative blood type.

Indications and contraindications for the use of immunoglobulin during pregnancy

The circulatory systems of the mother and fetus operate autonomously: their blood does not mix with each other. Rh conflict can occur when the placental barrier is damaged.

Human immunoglobulin during pregnancy is used to prevent isoimmunization of a woman when:

amniocentesis;
cordacentesis;
injuries of the abdominal organs;
the birth of a Rh-positive child;
positive blood from the child's father;
prevention of Rh conflict during the first pregnancy in the absence of sensitization of the woman;
premature;
severe form;
a number of infectious lesions;
diabetes mellitus

Among the contraindications to the use of immunoglobulin during pregnancy are:

allergic reactions;
negative blood group in women who have sensitization with the presence of antibodies;
positive Rh factor in a woman.

Methods of application

Normal human immunoglobulin during pregnancy is administered intramuscularly once. One dose of the drug is 300 mcg of anti-D immunoglobulin if the antibody titer is within 1:2000, or 600 mcg if the antibody titer is 1:1000.

It is forbidden to give an intravenous injection of immunoglobulin G during pregnancy.

Before use, it is necessary to leave the drug at a temperature of 18-22 ° C for 2 hours. To avoid foam, immunoglobulin is drawn into a syringe with a wide-lumen needle. An opened ampoule should be used immediately. Storing it open is unacceptable.

The drug is administered according to the following scheme:

the woman receives the injection within 48-72 hours after the birth of the child;
An injection of immunoglobulin for termination of pregnancy is performed after an abortion for more than 8 weeks.

If there are no antibodies in blood tests, immunoglobulin is administered at 28 weeks of pregnancy for prophylactic purposes. Next, the drug is injected after birth within 48 hours if the child’s Rh factor is positive. If the child has negative blood, then repeated administration of immunoglobulin is not required.

If a Rh-negative woman is at risk of spontaneous miscarriage, it is necessary to administer 1 dose of anti-D immunoglobulin during pregnancy.

For preventive purposes, an additional injection is prescribed during pregnancy, if amniocentesis is performed, or the woman experiences an abdominal injury. Next, the drug is administered according to the specified periods.

Consequences

The administration of normal human immunoglobulin during pregnancy may be accompanied by a number of side effects, among which the most important are:

redness of the injection site;
increase in body temperature to 37.5 °C in the first 24 hours after injection;
dyspeptic disorders;
allergic reactions, including anaphylactic shock.

Due to the fact that the drug is highly allergenic, after its use the woman’s condition is monitored for half an hour. If an anaphylactic or allergic reaction develops, first aid medications are administered.

Measures to prevent Rhesus conflict

To prevent the development of Rh conflict during pregnancy, it is necessary:

register for pregnancy up to 12 weeks;
if the mother has Rh-negative blood, take a test to determine the Rh factor from the child’s father;
if the father is Rh-positive, administer immunoglobulin according to the timing;
if the father is Rh-negative, do not vaccinate;
administer immunoglobulin during the second pregnancy and subsequent ones, if the mother is not sensitized;
administer the drug during any termination of pregnancy.

If an Rh-negative woman and an Rh-positive man are planning a pregnancy, it is necessary to undergo a series of medical examinations to prevent Rh conflict. To reduce the risk of developing hemolytic disease of the newborn, the mother is given immunoglobulin at 28 weeks of gestation. Further - according to indications in the postpartum period, if the child has inherited a positive Rh factor.

Pregnancy entails various metamorphoses in the body and these are not always changes in a positive direction. During this period, immunity is significantly reduced. The body itself provokes this process, consciously and purposefully.

Such an event is necessary for the successful bearing of a baby, so that the body itself does not perceive it as a foreign body, otherwise the fetus may be rejected.

Sometimes doctors use immunoglobulin during pregnancy, for example, for those who have problems with pregnancy. The drug can be administered in the form of droppers or injections. This drug is based on an active substance isolated from plasma, then purified and concentrated. Its action is aimed at immunomodulation and immunostimulation.

The product helps the body resist a variety of viruses and other microorganisms that cause diseases. Another feature of the drug is the replenishment of the level of IgG antibodies, which reduces the possibility of developing infections in women with primary and secondary immunodeficiency.

It is available in two forms: ready-made solution and powder. Available only by prescription.

When is immunoglobulin administration necessary?

There are two types of this drug: anti-D immunoglobulin and “normal”. These are completely different substances and each of them has its own indications for use. However, they are prescribed only in extreme cases when there is a serious danger to the patient’s health.

Pregnant women are prescribed immunoglobulin only if there is a real threat of premature birth or miscarriage. In addition, it is used in the event of pathologies (infections) that can affect the health of the fetus and the expectant mother. In addition, this remedy is used for the fairly well-known Rhesus conflict.

Anti-Rhesus immunoglobulin: what to do during pregnancy?

According to the results of medical statistics, it turns out that about 85% of people are Rh positive, the rest are Rh negative. Rh conflict occurs in two situations: when transfusion of Rh-incompatible blood; when a woman with Rh negative is pregnant with a child who is Rh positive. The last option involves the administration of anti-D immunoglobulin.

The immune system can divide any cells into “self” and “foreign”, but this protective function becomes a problem during pregnancy, when the mother’s body sees the embryo as a foreign body. After this happens, the female body begins to produce immunoglobulin antibodies.

When a foreign protein (antigen) is encountered for the first time, immunoglobulin M begins to be produced. It, in turn, transmits information about the encounter with the antigen to the B-lymphocyte, which synthesizes immunoglobulin G - specific antibodies that are created to interact with the antigen.

If there are antibodies to a specific antigen, then sensitization of the body occurs. The most significant thing for doctors is a woman’s sensitization to fetal red blood cells, that is, the incompatibility of Rh blood factors.

Rh conflict can cause anemia and jaundice in the newborn, and in some cases even more severe consequences - damage to the brain and heart of the fetus.

When does Rh conflict occur?

For infection;
Gestose;
Diabetes in pregnant women;
Medical manipulations;
During childbirth;
With placental abruption;
Ectopic pregnancy.

It follows from this that anti-Rhesus immunoglobulin may not be synthesized during the first pregnancy, which proceeds without complications. After the birth of a baby or termination of pregnancy, the likelihood of sensitization increases.

Prevention of Rh conflict

For a woman with negative Rh, it is necessary to minimize invasive procedures and avoid abortions. When transfusing blood, carefully check compatibility. Prevention of maternal sensitization to fetal red blood cells is now widely practiced.

There is a method that allows you to determine the level of anti-Rhesus immunoglobulins in the blood. During pregnancy, this analysis is carried out every month until 32 weeks, twice a month until 36, and then every week.

If, before the 28th week, antibodies to the baby’s red blood cells are not determined or their titer does not exceed 1 to 4, then at the same time they give a kind of vaccination - an injection of anti-Rhesus immunoglobulin during pregnancy intramuscularly (Rezonativ, HyperRow). This product is a ready-made antibody to red blood cells.

They will remain in the body for about 3 months and then are eliminated. If fetal blood enters the mother's bloodstream, the administered immunoglobulins will destroy it, so an immune response will not develop and sensitization will not occur.

Re-entry occurs within 72 hours from the moment the baby is born. This measure will reduce the risk of Rh conflicts in subsequent pregnancies. But a second anti-Rh injection is necessary only if, after the birth of the child, his Rh-positive blood was confirmed.

For the same purposes, anti-Rhesus immunoglobulin is used after abortions that took place after 8 weeks from the moment of conception, as well as for miscarriages, ectopic pregnancy or after premature birth, for abdominal injuries and at the end of invasive procedures (for example, cordacentesis and amniocentesis).

If at 20 weeks the titer of anti-Rhesus immunoglobulins exceeds 1 to 16, then the level of antibodies must be monitored every 2 weeks. At the same time, the doctor prescribes ultrasound, Doppler, CTG to monitor the condition of the child in the womb.

Sometimes in such a situation, when signs of hemolysis appear, the need for intrauterine blood transfusion to the fetus arises, and the question of premature birth also arises. The current circumstances strictly prohibit the administration of immunoglobulin.

Method of using immunoglobulin

The medicine is administered intramuscularly using an injection or intravenously by drip (dropper). In each individual case, the doctor determines the required dosage, guided by the woman’s individual tolerance and the state of her immunity.

Consequences of an intramuscular injection of immunoglobulin during pregnancy

It is worth noting that negative reactions from the body are very rare. When administering the drug, it is necessary to observe the dosage and speed of administration, and other recommendations must be followed.

Minor effects may appear during the first hour after administration of the drug. Usually these are phenomena such as: general malaise, headache, weakness, chills. In some women, the injection provokes a fever.

Pregnancy is not only a joyful and long-awaited event in the life of most families, but also a huge stress for the mother’s body. Women in this “interesting situation” experience a number of unfavorable manifestations, one of which is a significant decrease in natural immunity. At the same time, the body suppresses it purposefully - in a state of “full combat readiness” the fetus simply would not be able to take root.

Along with this, a decrease in immunity is fraught with a number of various consequences that pose a threat to both the expectant mother and the child developing inside her. To eliminate or at least minimize various kinds of negative manifestations, pregnant women are often prescribed the drug immunoglobulin, synthesized from human plasma and undergoing appropriate subsequent preparation.

The substance in question has an immunostimulating and immunomodulating effect on the patient’s body, which allows her to more effectively fight viruses and various infections, better resist primary and secondary immunodeficiency if present, and, which is also very important, minimize the possible negative consequences of Rh conflict.

As noted, the drug is used when there is a need to strengthen maternal immunity in the event of significant disorders that are not possible to cope with without the drug in question.

Important! The effect of immunoglobulin on the body of a pregnant woman remains not fully understood to this day. In view of this, the drug can only be used if there is an urgent need and exclusively under medical supervision.

Most often, immunoglobulin is given to a pregnant woman when a high risk of spontaneous miscarriage is detected. It is also often used to eliminate various kinds of progressive infections, treatment of which with antibiotics is not effective or is not possible.

An equally popular indication for prescribing the drug in question is Rh conflict, which develops in situations where the Rh blood levels of the mother and fetus are different.

According to the rules, the drug must be administered to the patient in a hospital. The possibility of outpatient use is excluded. The dosage is selected by the doctor individually, taking into account the characteristics of the particular patient’s condition and her pregnancy, the purposes of use and other significant factors.

Despite the lack of qualified medical research regarding the specific effects of immunoglobulin directly on the patient and the fetus developing inside her, in practice it has been established that no developmental pathologies have appeared in children while their mothers were taking immunoglobulin.

Like almost any other drug, immunoglobulin can provoke various kinds of negative reactions in the body, most often manifested by the following symptoms:

Features of prescribing the drug for Rh-conflict

As noted, immunoglobulin has proven itself well when used when Rh conflicts arise, for example, when the mother has a negative Rh factor, and the child developing inside her has a positive one. In such circumstances, in the absence of a timely response from specialists, the woman’s body can identify the fetus as a foreign body and begin to “attack” it with antibodies-immune globulins.

When a woman’s body first encounters proteins foreign to it, it begins to produce M-immunoglobulin a, which binds to the B lymphocyte. The latter, having received the appropriate signals, initiates the synthesis of class G immunoglobulin. This substance is antibodies that interact with antigens (third-party proteins) upon further contact with them.

If antibodies to a foreign protein are present in the body, the process of sensitization may begin, which in the case of pregnancy is manifested by sensitization of the mother's body to children's red blood cells.

The most commonly used method of classifying blood is its division into 4 groups and 2 rhesus. In conditions of incompatibility of Rh factors during pregnancy, very serious problems can arise. So, if the corresponding proteins are present on the surface of blood red blood cells, they speak of a positive Rh factor, in the absence of such proteins - a negative one. If the mother is Rh negative, while the fetus is Rh positive, sensitization is likely to occur.

Under such circumstances, the child's blood entering the maternal bloodstream will provoke the latter's body to produce anti-Rhesus immunoglobulins. Under the influence of these antibodies passing through the placenta, children's red blood cells are destroyed, which can lead to anemia, jaundice, and sometimes more severe side effects.

Along with this, if pregnancy occurs without significant complications, the production of antibodies may not occur. The situation is aggravated in the presence of infections, diabetes, gestosis, previous abortions, placental abruption and various types of pregnancy pathologies, for example, in the case of intrauterine development.

The procedure for using immunoglobulin is determined by a specialist, taking into account the characteristics of a particular situation. For example, first, to strengthen the body’s defenses, normal immunoglobulin can be administered, and 3 days after delivery, an IV with anti-D-immunoglobulin can be placed - these points are at the discretion of the doctor.

Rh factor
Father	Mother	Child	Probability of conflict
+	+	75% - 25% -	-
+	-	50% + or 50% -	50%
-	+	50% + or 50% -	-
-	-	-	-
Blood groups
Father	Mother	Child	Probability of conflict
0 (1)	0 (1)	0 (1)	-
0 (1)	A (2)	0 (1) or A (2)	-
0 (1)	AT 3)	0 (1) or B (3)	-
0 (1)	AB (4)	A (2) or B (3)	-
A (2)	0 (1)	0 (1) or A (2)	50%
A (2)	A (2)	0 (1) or A (2)	-
A (2)	AT 3)	any of 4 groups	25%
A (2)	AB (4)	0 (1) or A (2) or AB (4)	-
AT 3)	0 (1)	0 (1) or B (3)	50%
AT 3)	A (2)	any of 4 groups	50%
AT 3)	AT 3)	0 (1) or B (3)	-
AT 3)	AB (4)	0 (1) or (3) or AB (4)	-
AB (4)	0 (1)	A (2) or B (3)	100%
AB (4)	A (2)	0 (1) or A (2) or AB (4)	66%
AB (4)	AT 3)	0 (1) or B (3) or AB (4)	66%
AB (4)	AB (4)	A (2) or B (3) or AB (4)	-

In order to minimize risks both for the woman herself and for the child developing inside her, the expectant mother should adhere to a number of preventive recommendations, namely:

avoid various types of invasive interventions;
do not resort to artificial abortion procedures;
If it is necessary to transfuse donor blood, be sure to make sure that it is compatible with your own.

In addition, gynecology has means to control the concentration of anti-Rhesus immunoglobulins in the female body, i.e. In many cases, sensitization can be prevented with medication. Before reaching the 32-week period, the mentioned study is carried out monthly, after, up to the 36th week, twice a month, and then every week.

If there are no antibodies in a woman’s body before 28 weeks, or if their content is no more than 1:4, in most situations an injection of anti-Rhesus immunoglobulin is prescribed. That is, the patient is injected with antibodies, the “validity” of which lasts for approximately 12 weeks. Thanks to this, if children's red blood cells somehow manage to penetrate the maternal bloodstream, immunoglobulins will neutralize them, which will prevent the occurrence of sensitization.

If manifestations of hemolysis are detected, the doctor may resort to intrauterine blood transfusion to the fetus or even early delivery. Immunoglobulin is usually not administered under such circumstances.

Thus, the use of immunoglobulin in many cases makes it possible to minimize or eliminate the negative consequences of Rh conflict and a number of other undesirable manifestations. However, for treatment to be completely safe and effective, it must be carried out strictly under the supervision of a specialist, and the patient, in turn, must strictly follow his recommendations.