What is special about the negative Rh factor?
In general, a negative Rh factor does not cause any problems for its owner, as long as the issue does not concern surgery with blood transfusion, pregnancy or abortion.
In the first case, when a person with negative Rh is subjected to surgical or preventive procedures in a medical institution that involve the use of donor blood, he is required to undergo an analysis to determine Rh and only specific negative blood mass is used.
Abortion with a negative Rh factor poses a significant threat to the development of miscarriage in a woman in the future, so it can only be performed if absolutely necessary.
When the question concerns pregnancy, a Rh-negative mother may have difficulty carrying a Rh-positive child. This situation may arise if the father has positive Rh, in which case the probability of conceiving a child with positive blood is 50%. In all other cases there will be no conflict.
Considering the child’s “foreign” protein as a threat to its own body, the mother’s blood begins to form antibodies to it. During the first pregnancy, the problem is usually not as pronounced, because specific cells are just beginning to be produced and their number is not enough to cause significant harm to the baby. Difficulties begin during the second pregnancy, when the mother’s blood is already saturated with antibodies due to contact with the baby’s blood during childbirth or abortion. In this case, throughout the second pregnancy, the woman will be tested for the presence of antibodies, every 4 weeks, until 28 weeks. In the absence of antibodies at this time, antenatal prophylaxis is indicated - anti-RR(D) - immunoglobulin; if it was not carried out at this time, it is carried out as soon as possible, in the absence of antibodies. In the presence of antibodies, desensitizing therapy (hemosorption, plasmapheresis, immunosorption) can be carried out, but often these methods are ineffective. The only effective method is intrauterine intravascular blood transfusion to the fetus.
Attention! If a woman with negative Rh wants to have children, then it is extremely important for her to try to give birth to a child during her first pregnancy. Although this must be done under the supervision of an experienced doctor. Abortion with negative Rh or spontaneous miscarriage entails quite serious consequences.
What is a medication method?
Replacing the surgical instrument and vacuum aspirator with hormonal drugs made it possible to develop a method of pharmacological abortion. This is a non-invasive procedure for getting rid of pregnancy in the early stages, which occurs like a spontaneous miscarriage.
Its advantages are associated with the following factors:
- efficiency 98-99%;
- no possibility of injury to the uterus or cervix during surgical procedures;
- low risk of ascending infection;
- there is no danger of getting HIV, hepatitis;
- there are no risks caused by anesthesia;
- can be used in primigravidas, the effect on women's health is minimal;
- low level of stress, does not create a traumatic situation.
The procedure does not require a long hospital stay. After the patient has taken medications that cause a medical abortion, bleeding can be expected at home. But self-administration of medications without a doctor is impossible.
Which is better, vacuum abortion or medical abortion?
Risks of negative blood
Any abortion itself poses a threat to the health and reproductive function of a woman, and in a negative Rhesus carrier it can cause the development of hemolytic disease of the fetus, which will lead to its death.
The first abortion is especially dangerous for women with a negative Rh factor. Although the pregnancy may only last a few weeks before the abortion, the antibodies will remain in the body. The woman will receive a kind of immunity for being Rh positive. As a result, subsequent pregnancies may end in miscarriage or fetal death. The only favorable circumstance is that the father of the unborn child has the same negative blood. In this case, there will be no conflict and abortion will not be any different.
Important! An injection of anti-Rhesus immunoglobulin partly helps to solve the problem of Rh conflict. It must be done within a few hours after the abortion.
How to reduce the risks of negative consequences
To ensure that the abortion is as safe as possible and does not cause serious health problems, women who have a negative Rh factor should adhere to the following recommendations:
- When deciding to have an abortion, you should have the procedure done as soon as possible. Firstly, termination of pregnancy in the early stages is possible using gentle methods that do not cause serious damage to health. And secondly, at 5-6 weeks the fetal circulatory system is not yet fully formed, therefore antibodies in the woman’s body have not yet begun to be produced;
- After an abortion, a woman must be given anti-Rhesus immunoglobulin by injection in the next three days. This will stop the production of antibodies and reduce the risk of Rh conflict in the future.
Possible consequences
If an abortion is performed when Rh is negative, the pregnant woman is immunized with fetal red blood cells. This leads to an increase in the number of anti-Rhesus antibodies that penetrate into the bloodstream of the unborn child, which leads to severe disturbances and inhibition of the process of hematopoiesis of the embryo.
The consequences of an abortion with negative Rhesus can be as follows:
- severe anemia;
- intrauterine fetal death;
- disruption of internal organs;
- hemolytic disease;
- fetal hypoxia;
- miscarriages, stillbirths;
- encephalopathy.
Thus, it is very dangerous to have an abortion if you are Rhesus negative. Among other things, during an abortion, the cervix is often injured, the upper layer of the endometrium becomes thinner, and a perforation may form. Echoes of such intervention are hormonal disorders, inflammatory processes, and the inability to become a mother.
Also, after an abortion with negative Rh, a complication such as cervical insufficiency occurs, which affects its obturator function. This can lead to late miscarriage because the cervix begins to dilate prematurely, unable to support the growing weight of the baby.
Indications for abortion with negative Rhesus
A negative Rh factor in itself is not a reason to terminate a pregnancy. Abortion for medical reasons is prescribed in the following situations:
- if pregnancy poses a threat to the life of the mother with severe heart defects, kidney disease, cancer and others;
- if the fetus has developmental pathologies incompatible with life in utero;
- if a woman in the early stages suffered from an infectious disease that is particularly dangerous for the intrauterine development of the child.
There are other indications in which the life and health of the mother or unborn child are at risk. Each case is considered individually by the medical council.
By law, a woman has the right to terminate a pregnancy up to the 3rd obstetric month at her own request or under special social conditions. However, if she has Rh-negative blood, she should try with all her might to save the child.
Indications
Indications for abortion include social reasons or those related to the health of the woman and the unborn child. More often it is:
- financial difficulties;
- fear for the unborn child;
- housing and family problems;
- a woman’s illness incompatible with pregnancy;
- criminal pregnancy;
- severe developmental disorders of the fetus or its death.
Anemia also has a bad effect not only on the condition of the pregnant woman, but also on the development of the fetus. Anemia is a bad companion to pregnancy; a worsening condition may become an indication for artificial termination of pregnancy.
Types of abortion for negative Rhesus
To terminate a pregnancy, both with negative and positive Rhesus, medical and surgical abortion methods are used. The choice is made by the attending physician based on the studies performed, the duration, the presence of complicating factors or pathologies. However, the safest and most gentle method is always chosen.
Medical abortion
The method consists of taking special pharmacological drugs that block the action of progesterone at the receptor level, slow down and stop the development of the embryo, and detach the fetal membrane from the walls of the uterus. Another group of prostaglandin agents stimulates muscle contractions of the myometrium and the subsequent removal of the frozen fertilized egg from the uterine cavity. In general, the procedure resembles heavy menstrual bleeding, although the hormonal load on the body is quite serious. Pain relief is used symptomatically for several days after the abortion.
Vacuum aspiration (mini-abortion)
This method refers to minimally invasive surgical interventions. The interruption is carried out in the clinic using a vacuum pump, which creates negative pressure in the uterine cavity through an aspiration catheter and promotes detachment of the fertilized egg along with the endometrium. This type of interruption is performed using local or general anesthesia (anesthesia).
When using local anesthesia, there is no need to involve an anesthesiologist; all manipulations are performed by a gynecologist or nurse. It is much easier for a conscious woman to control her breathing and heartbeat, so there is no need for resuscitation equipment. Restoration of sensitivity occurs gradually. If the pain intensifies, the woman will have time to take an analgesic tablet. After the procedure, there is slight bleeding for several days.
Curettage (curettage)
Using surgical instruments, the cervical canal is expanded and fixed. Using a sharp instrument (curette), the gynecologist separates the embryo from the walls of the uterus, removes parts of the fetus from the cavity and removes the inner mucous layer of the endometrium. All manipulations are performed in a hospital under general anesthesia.
Attention! Any careless movement during surgery can lead to tissue rupture, damage to adjacent organs, and scarring, so a woman should trust her health only to a qualified specialist.
General anesthesia has a fairly strong effect on the body. Even a healthy woman suffers from its consequences. If the patient has recently undergone a similar procedure, the load on the body should be reduced.
Which abortion is riskier with Rh-?
Modern medicine offers 3 methods of abortion: medication, vacuum aspiration, curettage. The type of abortion is chosen by the gynecologist depending on the gestational age and the woman’s health condition. The woman’s Rh factor is also taken into account, because some methods of termination cause more complications for subsequent pregnancies than others.
Medical termination of pregnancy
Medical abortion is considered the most gentle and safe for the female body. It is allowed to be carried out only in the early stages of gestation. The WHO has set a maximum period of 12 weeks, but in Russia pregnancy is terminated using pharmacological drugs only up to the 6th week.
A woman takes a pill that contains a synthetic steroid antiprogestogen. It blocks progesterone receptors, which leads to increased myometrial contractility. The sensitivity of the uterus to prostaglandins increases, which contributes to the expulsion of the fertilized egg.
There are virtually no complications after a medical abortion, but is it suitable for women with negative Rh? On the one hand, it is performed during the gestation period when the circulatory system has not yet formed in the embryo. On the other hand, during a pharmaceutical abortion, heavy bleeding begins, so the likelihood of the formation of anti-Rhesus antibodies is high.
Vacuum method
Another type of abortion is vacuum aspiration. The gynecologist inserts a syringe with a flexible cannula at the end into the uterus. This tube is connected to an electric pump that, when turned on, sucks the fertilized egg out of the uterus. The operation lasts no longer than 15 minutes, but is performed under local or general anesthesia. The maximum period during which vacuum aspiration can be performed is 12 weeks.
Women with a negative Rh factor are most often prescribed a vacuum abortion. During the procedure, the endometrium is damaged in small areas, the risk of bleeding is quite small, which means there is a high chance that the woman’s blood will not come into contact with the blood of the fetus.
Surgical abortion
Surgical abortion is performed using the curettage method. The gynecologist first dilates the cervix by dilation and then scrapes out the uterine cavity using a curette. This is a painful and traumatic procedure, so it is performed only under general anesthesia. Curettage often leads to the following consequences:
- perforation of the uterus;
- incomplete abortion;
- cervical rupture;
- inflammatory processes;
- acute blood loss.
During curettage, bleeding is inevitable. According to WHO statistics, 64.5% of women undergo Rh immunization after curettage, while after vacuum aspiration the percentage of formation of anti-Rh antibodies is lower - 48.8%.
Surgical abortion with a negative Rh factor is prohibited, but it is resorted to when the deadline for other types of termination of pregnancy has already been missed, and further pregnancy is dangerous to the health or life of the woman. After the surgical procedure, the woman should be given anti-Rhesus immunoglobulin to prevent complications.
Hello! Today I have a sad topic, inspired by a story from mom’s groups. The girl wrote about how doctors stubbornly persuaded her to have an abortion according to indications, and how she resisted. I wondered how to make the right decision if doctors insist on a forced interruption, and the woman has contraindications. For example, negative Rh factor.
This fall, only the lazy did not write about the church’s initiative to ban abortion. Among the arguments of opponents, the need to terminate pregnancy for medical reasons was in first place. Such an abortion is called “forced” and presupposes the presence of serious diagnoses in the fetus or mother (ectopic pregnancy, pathologies incompatible with life, threat to the life of the mother, etc.).
At the same time, everyone somehow forgot that for some women interruption is, in principle, contraindicated. For example, an abortion with a negative Rh factor in the mother’s blood very often leads to subsequent attempts to have a child ending in miscarriage or infertility.
After an abortion, it is especially difficult for the body of such women to recover, therefore, even if you have an unwanted pregnancy and do not have the Rh factor in your blood, think ten times about the consequences before making a final decision.
Optimal timing of abortion for negative Rhesus
If a woman with negative blood has grounds for an abortion, it is important to have it as early as possible. At week 7, the hematopoietic system begins to form, so it is better to have an abortion before this period, which increases the likelihood of a successful re-pregnancy many times over. Therefore, abortion at 6 weeks inclusive would be the best option.
If a woman has no contraindications to medical termination of pregnancy, then it is better to choose a pharmaceutical abortion, which is allowed up to 9 weeks. It will not affect the internal structures of the pelvic organs (myometrium, cervical canal), and the likelihood of infection from the outside is almost completely eliminated.
If these deadlines are missed, vacuum-aspiration or surgical abortion is chosen (up to 12 weeks).
If termination of pregnancy was necessary
Sometimes pregnant women are forced to agree to an artificial interruption because there are appropriate indications. That is, while carrying a child, the mother is in danger, and the consequences of termination will not be as serious as from the pregnancy itself.
A thorough examination is carried out first. It must be remembered: a pregnancy interrupted before the 7th week will cause minimal consequences, since the production of antibodies has not yet begun during this period.
What happens if this time is missed?
- Weeks 7-9 is the period when the fetus’s hematopoietic system is actively developing.
- The female body tries to produce antibodies to get rid of the threat.
Removing the fetus using curettage in the later stages can provoke:
- endometrial damage;
- development of inflammation.
It can be very difficult for such women to subsequently become pregnant due to difficulties associated with the attachment of the embryo. In addition, there is little chance that the baby will be born healthy.
Actions after an abortion
It is critically important after any abortion with negative Rhesus to give the woman anti-Rhesus immunoglobulin, which will stop and neutralize the production of antibodies. The injection must be given within 72 hours after the procedure. This will help reduce the likelihood of hemolytic disease of the fetus in the next pregnancy, although it does not guarantee 100% success.
Also, during the period of recovery of the body, a woman needs to choose a vitamin complex and adhere to a balanced diet.
To prevent infections, it is important to maintain good hygiene. You can only use gaskets. You should avoid sitz baths, hot showers and saunas for the next 14 days. Sexual activity is stopped for 3-4 weeks.
Attention! To prevent inflammatory processes, the gynecologist prescribes a course of antibiotics, if indicated. It is important to remember that taking them is incompatible with drinking alcohol.
Consequences of abortion with negative Rhesus
Not a single abortion goes unnoticed for a woman; the consequences differ only in severity. With a negative Rh factor, termination of pregnancy is aggravated by the fact that the future of unconceived children is jeopardized.
The most serious complication is Rh immunization, in which antibodies to the Rh+ antigen are formed in the blood of the failed mother.
Consequences of Rh conflict for future pregnancy:
- early miscarriages or stillbirths;
- enlarged liver, kidneys, heart;
- anemia;
- erythroblastosis or hemolytic anemia (destruction of red blood cells).
An infant is born with hemolytic disease of the newborn, which results in jaundice. In especially severe cases, dropsy and edema syndrome develop, and the baby dies soon after birth.
Abortions with negative Rh are extremely dangerous if performed surgically in the later stages.
The first abortion seriously disrupts hormonal levels and damages the walls and cervix during surgery, which can lead to infertility. Violation of the endometrial mucosa leads to a chronic inflammatory process of the organ.
Attention!
This article is posted for informational purposes only and under no circumstances constitutes scientific material or medical advice and should not serve as a substitute for an in-person consultation with a professional physician. For diagnostics, diagnosis and treatment, contact qualified doctors!
Symptoms of Rh conflict
If you do not diagnose in time and do not have an idea about the state of the mother’s blood in advance, you can get a number of unpleasant consequences. During pregnancy, signs of hemolytic disease will be observed. Minor disturbances in the functioning of organs often occur. At the stage of fetal development, any deviation can lead to irreversible damage.
If the birth is successful, then the Rh conflict between mother and fetus will have a negative impact on the condition of the newborn. Jaundice and anemia may develop. Due to lack of oxygen, serious damage to the brain and heart was observed.
