A child who grows in the mother's womb during the entire pregnancy is only half akin to her according to genetic data, since male genes brought into the egg by the sperm also took part in the formation of the new organism. And it becomes clear that the woman's immunity perceives the baby as something alien. However, fetal rejection does not occur, since immunity is naturally suppressed.
But the natural mechanisms of immunosuppression are not enough for Rh-conflict between mother and child. In this case, it becomes necessary to use anti-rhesus immunoglobulin.
Indications
All pregnant women do not need anti-rhesus immunoglobulin. As already mentioned, nature has provided for the possibility of bearing a fetus, therefore even the overly zealous immunity of the expectant mother at the earliest stages begins to be suppressed by progesterone, which ensures the bearing of the child even in cases where the immunity was initially "against".
Rhesus immunoglobulin is a drug intended for pregnant women with a negative Rh, provided that the pregnancy came from a Rh-positive partner. In this case, there is a possibility that the child will inherit the mother's "negative" blood, but there is also a high probability that the fetus's Rh factor will be positive.
The baby's blood cells enter the mother's bloodstream after about 9 weeks of pregnancy, and it is they that are regarded by the immunity of the expectant mother as aggressors. Immunity begins a large-scale attack on the blood cells of the child, more precisely, on the protein, which is a sign of positive Rh status.
Rh-conflict, severe immunological incompatibility between mother and fetus develops. This is fraught with miscarriages, frozen pregnancy, premature birth, the development of hemolytic disease of the fetus and newborn, and numerous complications in the child's health in the future.
For the production of immunoglobulin, which is able to prevent conflict, human blood cells are used, which are specially purified and include antibodies. Anti-rhesus serum, in essence, is a fraction of a protein, dissolved in physiological solution, isolated from donor blood, which has been thoroughly tested for HIV, syphilis and hepatitis. Incomplete anti-Rho (D) antibodies are included in the product. Transporting them into the pregnant woman's blood helps prevent Rh sensitization.
Consider what circumstances are considered important for the appointment of an antiresus injection. There are several of them, but the main one is that the patient has a negative Rh factor, and her partner has a positive one. An injection of the drug is prescribed in the following cases.
- When carrying a fetus and after the birth of a child with a positive Rh factor. This is very important for subsequent pregnancies, since next time there will be even more antibodies in the blood of the expectant mother, so negative consequences for the baby will become more likely.
- After miscarriage or artificial termination of pregnancy for women with Rh negative blood.
- After an ectopic or frozen pregnancy.
- If there is a threat of miscarriage in any trimester, if the expectant mother has a Rh-negative status.
And also administer the drug to women after amniocentesis and other invasive procedures, because after them there is a great risk of mixing the blood of the mother and the fetus.
Without fail, an anti-Rh immunoglobulin is administered to a pregnant woman with a negative Rh status, if she injured her stomach, fell unsuccessfully, received a blunt trauma to the abdominal cavity.
In this way, the drug can be used as a means of prenatal prevention of Rh-conflict - planned at 28-30 weeks of pregnancy and within 72 hours after childbirth, when it is confirmed that the baby was born with a positive Rh factor inherited from his father. This is a kind of vaccination against Rh-conflict in the future.
In all other cases listed above, emergency use of the drug is provided.
How is the drug administered?
Pregnant women are given an injection in the treatment room of the antenatal clinic by written prescription from a doctor. The second injection is given already in the hospital within three days after the birth of the child. After childbirth, there is a need for vaccination only when the child is diagnosed with a positive "father's" Rh factor.
For emergency administration, dosages are calculated on the spot, depending on how much incest between the mother and the fetus in the event of trauma, invasive procedure, and so on.
With the development of a threat at any time, one average dose of immunoglobulin is administered in a hospital setting or in a antenatal clinic.
After an abortion, miscarriage, cleaning, ectopic pregnancy, the drug is administered immediately after surgery or manipulation.
In all cases, the drug is injected deeply intramuscularly. The reports of many women's sites that immunoglobulin can be administered in the form of a dropper are not true. The manufacturer does not provide for and is contraindicated for intravenous administration of the drug.
Are side effects possible?
The drug does not affect the fetus, since it is considered completely safe for the development and growth of the baby, so future mothers may not worry. In addition, the remedy is considered safe for the pregnant woman herself, and the injection is usually well tolerated.
Instructions for use of this tool indicate the need to observe the woman's condition after the injection for at least an hour. But this is more a precautionary measure than a justified procedure.
In some cases, the body temperature may rise slightly, a feeling of weakness, headache, nausea may appear.
At the injection site, short-term redness and moderate itching are not excluded. Severe consequences (for example, anaphylactic shock) are only possible in theory. But the probability itself forms the need to monitor the condition of the expectant mother or postpartum woman after the administration of the drug.
Are there any contraindications?
Do not administer the drug to women with a positive Rh factor, as there is no need for it. And for women with a negative blood factor, the list of contraindications is small. It includes:
- a history of a severe allergic reaction in response to the administration of any immunoglobulin, which is quite rare;
- detection of an increased titer of antibodies in the woman's blood, which indicates that sensitization has already begun, therefore, there is no longer a need for immunoglobulin, but also no sense.
In the second case, treatment of the Rh-conflict should be started, the purpose of which will be to minimize the negative consequences for the baby.
Overdose
For many years, the use of such a drug has not shown cases of overdose; such cases are not described in the scientific and medical literature.
Interaction with other drugs
With other drugs, anti-rhesus immunoglobulin does not enter into a reaction, it can be administered on time and against the background of taking hormonal drugs, and against the background of antibiotics, if such treatment is prescribed to a woman for a number of reasons.
What are the terms of sale
The product is sold exclusively by prescription. The drug is supplied to medical institutions centrally, and therefore the question of buying a drug should not worry a woman. If she is entitled to the introduction of immunoglobulin, then this drug is in a medical institution - both in the consultation and in the maternity hospital.
Storage conditions
Storage of ampoules-syringes requires special treatment from medical personnel. At high temperatures, the composition changes and the preparation becomes unusable. It is recommended to store the product at a temperature not lower than 2 degrees Celsius and not higher than 10 degrees, that is, in a refrigerator. Under the same conditions, it is prescribed to transport the vehicle.
Do not use ampoules with broken integrity, as well as fuzzy or missing markings.
Shelf life
Limited to 3 years from the date of issue. Then the product must be disposed of.
Special notes
If the expectant mother was injected with an anti-rhesus immunoglobulin after giving birth or before them, the first scheduled or unscheduled vaccinations using live vaccines can be done only 3 months after the administration of the immune preparation.
When registering for a Rh-negative woman, it is important to invite a doctor and a partner to an appointment with a doctor during the first or any subsequent pregnancy. He is also given a referral for a blood test. This is necessary to confirm the Rh-origin of the father of the unborn child. If the dad also has a negative Rh factor, there is no need to inject the drug either during pregnancy or after childbirth.
Women who are given such an injection according to the available indications are given the drug free of charge... These are the clinical recommendations of the Ministry of Health on the management of pregnancy complicated by Rh-related women. The price of the drug in this case is of no practical value for expectant mothers. They also do not charge fees for postpartum women who are injected with the drug within three days after the birth of a child with a positive Rh factor.
The injection is also free for patients after abortion and other situations.
And this is very good, since the market price of the drug ranges from 3 to 7 thousand rubles.
Reviews
According to the reviews of women who were injected with such a drug during pregnancy, there were no side effects, effects, complications after the injection. It is noteworthy that none of the mothers reports on the development of a severe hemolytic disease in the child after the injection. This indicates the effectiveness and proven safety of the product. After childbirth, the remedy also did not cause any side effects.
Very often women report that they are being asked for money for staging an injection - up to 7 thousand rubles. Anti-Rhesus Immunoglobulin is included by the Government of Russia in the list of vital drugs, therefore, a fee cannot be charged for it if a woman is registered with an antenatal clinic and has a compulsory medical insurance policy.
If a pregnant woman prefers to be monitored in a private medical center, then along with doctor's appointments, analyzes and ultrasound examinations, she also pays for the cost of immunoglobulin. You shouldn't be surprised at this.
