Miscarriage with negative Rh factor: Causes, Prevention

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.

What is the danger of this phenomenon

The blood type and Rh factor are different for each organism. When mixed, a number of disturbances begin to occur in the functioning of many organs, including vital ones. Before blood was analyzed in detail, transfusion was a very risky decision.

During pregnancy, a hemolytic disorder occurs. Many antibodies produced in the mother’s body will appear in the blood of the fetus and begin to actively fight Rh positive.

This leads to jaundice in the unborn child, and in worst cases, miscarriage.

Disturbances may affect the brain and other vital organs. If a woman has a negative Rh factor, it is necessary to use special treatment methods and take medications. Modern methods significantly reduce negative consequences.

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.

The concept of Rh factor

Rhesus is a special protein substance that is attached to the cell membranes of red blood cells. It has antigenic properties. People who have this antigen in their blood are called “Rh-positive” (Rh (+)), and those who lack the protein substance are called “Rh-negative” (Rh (-)).

Such a division does not have much impact on people’s lives. Rhesus is taken into account in case of major bleeding, when the question of blood transfusion arises. There are six to seven times fewer Rh-negative people than Rh-positive people, so if a person has a rare GC (for example, IV), he will have to look for a donor.

In people who do not have the Rh antigen, immune protective reactions are expressed, for example: implant rejection occurs more often. Therefore, Rh (-) is of greatest importance for pregnant women whose fetus inherited Rh (+). This is dangerous due to sensitization (a pronounced response of the immune system to foreign irritants - allergens) of the female body, which mistakes the embryo for a foreign body.

A separate question is: is it possible to have an abortion with negative Rh? To answer it, you need to understand the essence of the Rh conflict and the danger of the consequences.

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.

Save cannot be interrupted: why is abortion undesirable for an Rh-negative woman?

Why is abortion with negative Rhesus extremely undesirable? Rhesus conflict develops only when the blood of mother and baby is mixed. The first pregnancy most often passes without consequences for the fetus.

Blood contact occurs during childbirth, miscarriage, placental abruption or abortion. The mother's body produces antibodies that attack the fetus during the next pregnancy.

So where do you put the comma in the statement “save cannot be interrupted”? The woman makes the decision on her own. There are two ways to minimize the risks of complications:

terminate pregnancy before 8 weeks, when the embryo has not yet formed its own blood cells;
within 3 days, administer anti-Rhesus immunoglobulin, which suppresses the production of antibodies.

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.

Methods of abortion

Several methods of abortion are used in medicine. They differ in the method of extracting the fertilized egg and the risk of complications:

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).

Is it possible to have an abortion with low hemoglobin?

Most experienced doctors refuse to perform an abortion on a patient who has a low hemoglobin concentration. Carrying out such an operation can provoke the development of:

hypertension and heart failure,
swelling,
renal dysfunction,
intestinal infections and gastrointestinal diseases,
chronic fatigue and decreased immunity.

It can also negatively affect the health of future children.

Before deciding on such a procedure, a woman should think carefully and weigh the pros and cons.

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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.

How is the time for an abortion determined?

The timing for medical abortion is determined by the protocol of the Ministry of Health of the Russian Federation dated October 14, 21015. They record that it is possible to carry out a gestational disorder up to 63 days, or the 9th week. But in world practice there are differences in how long this manipulation can be done. In developed countries, the period is defined as 49 days, or 7 weeks of pregnancy.

Why is such a period determined for pharmacological interruption?

At the 5th week of pregnancy, the embryo begins to acquire human features, the rudiments of many organs and the umbilical cord appear. At week 6, the placenta begins to form, and internal organs continue to develop. At week 8, the embryo already has a completely human appearance and enters the fetal stage. After this period, the formation of blood vessels in the placenta occurs, so a medical abortion can cause heavy bleeding.

The following drugs for medical abortion are registered and used in Russia:

Mifepristone 200 mg.
Misoprostol 200 mcg.

Pharmacological abortion during a frozen pregnancy can be used if the gestational age corresponds to that permitted by the protocol. The main condition for the successful completion of the procedure is the day of pregnancy and the presence of an embryo inside the uterus according to ultrasound results. After a caesarean section, the medical method is preferable to other methods.

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!

Rh negative and pregnancy

The main problem when a Rh-negative mother carries a Rh-positive child is the production of antibodies by the pregnant woman’s immune system against fetal antigens that have entered the blood. During the first pregnancy, the likelihood of mixing the blood of the baby and mother is minimal, which allows you to carry and give birth to your first child without complications.

But the first birth, abortion, miscarriage or placental abruption lead to the woman’s immunization with the baby’s red blood cells, which contributes to the body’s production of special antibodies, which in future pregnancies will attack the Rh-positive fetus, leading to sensitization.

Important! Sensitization that occurs against the background of Rh conflict is possible due to the immune memory of the cells, which has retained information about the first contact with the antigens of the embryo.

The onset of sensitization occurs unnoticed by the pregnant woman. This condition is determined by the content of antibodies in her blood (their titers), a large number of which indicates the severity of the pathological processes for the child. The degree of fetal damage is determined by ultrasound results. Sensitization leads to:

compaction of the placenta,
child's weight gain,
swelling,
an increase in the size of the heart and other organs, which leads to their dysfunction,
accumulation of fluid in the skull and abdominal cavity,
fetal hypoxia,
development of severe anemia,
the appearance of encephalopathy,
the occurrence of hemolytic disease.

Such consequences occur due to hemolysis (death) of red blood cells, which leads to severe intoxication of the fetus with decay products. Therefore, delay in taking appropriate measures is fraught with fetal acidosis (death inside the womb).

At what rhesus factor can you not have an abortion?

There are situations in life when the onset of pregnancy causes not joy, but grief. There can be a large number of reasons for this, and a woman often decides to have an abortion. Such intervention in the body is a risk, no matter how professional it is carried out.

And if a woman has negative Rh, then termination of pregnancy can subsequently result in infertility or such a tragedy as the birth of a still child. In addition, after an abortion during a subsequent pregnancy, the likelihood of an Rh conflict increases. So why is abortion dangerous if you have a negative Rh factor? Let's try to figure this out.

Why does Rh conflict develop?

The membrane of blood cells (erythrocytes) contains the Rh antigen. Such people's blood has a positive Rh factor, and they are the majority worldwide - 70-85%. Otherwise, there is no Rh antigen in the blood, so it is considered negative.

Starting from 7-8 weeks, the formation of hematopoiesis occurs in the fetus.

If a woman is Rh negative and the embryo is positive, then the pregnant woman’s body may perceive it as a foreign body and begin to produce specific anti-Rh antibodies.

If this is the first pregnancy, then their number is quite small and the likelihood that the fetal blood will enter the mother’s bloodstream is minimal. In this case, the woman safely bears and gives birth to a healthy child.

But during an abortion, a pronounced sensitization of the body occurs. During the next pregnancy and repeated contact with foreign antigens, an active release of specific anti-Rhesus antibodies almost always occurs. This happens due to the fact that immune memory cells store information about the primary contact between the blood of the fetus and the mother.

Signs of Rh conflict

A pregnant woman may not notice the development of Rh conflict. It is diagnosed by the presence of specific antibodies in the blood. The higher their concentration, the more severe the pathological process will be. The fetus itself also suffers greatly. Abnormalities in the unborn child are easily detected by ultrasound. It could be:

swelling;
increased heart size;
acute fetal hypoxia;
fluid in the brain, abdominal cavity;
thickening of the placenta;
large fruit mass.

If no measures are taken to prevent the development of Rh conflict, severe fetal abnormalities lead to its death.

Carrying out an abortion with negative Rhesus

If a woman is Rh negative, can she have an abortion or not? Of course, this is undesirable, but if a decision has been made to terminate the pregnancy, then you need to know that it must be done before 7-9 weeks. After this, the formation of the hematopoietic system occurs, and the risk of sensitization of the maternal body increases.

It happens that abortion in case of Rh negative is carried out for medical reasons. The main thing is to prevent sensitization from developing. Medical abortion is usually performed early in pregnancy. Immediately after this, the patient is administered anti-Rhesus immunoglobulin, but the likelihood that an Rh conflict will arise during a subsequent pregnancy still remains.

Any abortion is associated with the risk of infertility, and if it is performed on a woman with negative Rh, then miscarriages may constantly occur in the future, and there is a high probability of having a child with hemolytic disease, as well as with various abnormalities.

Late-term abortion, which is performed surgically, is very dangerous. Scraping the fertilized egg from the uterine cavity damages the endometrium and promotes inflammation.

In the future, this may become an obstacle to the implantation of the embryo and the normal course of pregnancy.

Types of abortions

If a woman has a negative Rh factor, then she can undergo the following types of abortions:

Medication - carried out using special tablets, which is why the embryo begins to spontaneously reject. In this case, bleeding continues for quite a long time, but this option is considered the safest for a woman’s health.
A mini-abortion is a non-surgical method of terminating a pregnancy, carried out by a special device, and its operating principle is similar to a vacuum cleaner.
Surgical is considered the most dangerous method, since the uterine cavity is scraped out blindly. This can lead to a large number of complications.

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.

Source: https://psyfisis.ru/pri-kakom-rezuse-nelzja-delat-abort/

What blood type can't have an abortion?

Unwanted pregnancy leads many women to abortion. However, not everyone knows what consequences an abortion with negative Rhesus may entail.

What does “Rh negative” mean?

The Rh factor is an antigen, a protein that is found in red blood cells and is responsible for the compatibility of the blood of mother and child. Most people have it in their blood, but 15 percent of the population does not have it. Such people have a negative Rh factor. The fact itself does not affect the human body in any way.

However, problems begin when partners planning a pregnancy have different Rh factors: the child may inherit “positive” from the father, which is incompatible with the “negative” of the pregnant mother.

The woman’s body will begin to produce antibodies to fight the foreign body (that is, a child with a different Rh), and this poses a threat to the fetus.

Antibodies produced by the mother's body can cross the placenta to the fetus and lead to oxygen starvation, developmental disorders and even miscarriage.

What is Rh conflict?

The situation described above, when the mother's antibodies attack the fetus with a different Rh, is called Rh conflict. It is detected by the presence of these “protector” antibodies in a woman’s blood.

The severity of the conflict is determined by the antibody titer. As a result of the conflict, the fetus can suffer greatly.

Ultrasound detects abnormalities such as swelling, thickening of the placenta, enlarged heart, and enlarged liver and spleen.

However, medicine is now quite successfully combating the problem of Rh conflict in pregnant women. There is special treatment for resolving Rhesus conflict, and under good medical supervision a woman has practically nothing to fear.

Why is abortion dangerous for “negative” women?

A negative Rh factor makes not only pregnancy risky, but also abortion. There are several reasons for this, the main one being the threat of infertility. It does not matter what type of pregnancy termination a woman decides on, surgical or medical. Neither one nor the other will pass without a trace for a female body with a negative Rh factor.

Abortion with a negative Rh factor during the first pregnancy is extremely dangerous. In fact, this is the first meeting of an Rh-negative organism with Rh-positive blood (if the child took the blood of a “positive” father).

If a woman is pregnant for the first time, the antibodies that her body produces can hardly penetrate the placenta; they are large and inactive.

That is why, even in the presence of Rh conflict, a woman has a good chance of giving birth to a healthy child.

What happens if a woman misses this opportunity and still decides to have an abortion? The blood of the mother and child will mix, the production of antibodies will increase, and during the next conception the mother’s body will be much better prepared to meet a foreign object (the child). Antibodies will become smaller, more mobile and more dangerous for the baby.

Each abortion performed by a negative woman increases the risk of developing abnormalities in subsequent pregnancies by 10 percent. It turns out that after having several abortions, a Rh-negative woman at one point simply loses the chance of normal pregnancy.

In addition to the high risk of infertility, abortion with a negative Rh factor can lead to other complications. These include hemolytic disease, encephalopathy, an increased risk of miscarriage in the next pregnancy, and anemia.

What if abortion is a necessary measure?

Unfortunately, the decision to have an abortion is not always the woman’s initiative. Sometimes it is necessary to terminate a pregnancy for medical reasons, and the consequences of carrying a fetus pose more dangers for a woman than the consequences of an abortion.

An abortion is carried out on the recommendation of a doctor as a result of a thorough diagnosis. In any case, a woman should know that the negative consequences of such an abortion are minimal if the pregnancy is terminated before the seventh week, before the body begins to produce antibodies. The risk of sensitization (development) is thus minimized.

The fact is that at seven to nine weeks the fetal hematopoietic system is already developing, and antibodies are produced to attack the threat that has arisen. There is an interaction between the mother's blood and the fetus' blood. A woman's body produces even more antibodies. By her next pregnancy, he will be much better prepared to “protect.”

Late-term abortion is especially dangerous. Curettage of the uterus is always associated with damage to the endometrium and the development of inflammatory processes.

After such a late abortion, it is very difficult for a woman who has a negative Rh factor to become pregnant and carry a healthy baby.

The fact is that in the future, during the next pregnancy, it will be difficult to attach the embryo and carry the fetus.

What are the features of an abortion with a negative Rh factor?

If a woman undergoes a medical abortion, the embryo will spontaneously be rejected. Among the bloody post-abortion discharge, a woman can find the embryo itself. The discharge continues for quite a long time.

After an abortion, the administration of anti-Rhesus immunoglobulin is required, the purpose of which is to stop the production of antibodies. Usually this procedure is performed in the first 3 days after an abortion. Its importance lies in the fact that it reduces the risk in subsequent pregnancies. However, the likelihood of detecting a Rh conflict will still remain.

Bleeding is also possible after a mini-abortion. It can last up to ten days. At this time, you should be especially careful about your own health and not be exposed to harmful factors, as your susceptibility to infections increases.

For all of the above reasons, women with a negative blood type should not have an abortion unless it is for medical reasons. If a woman with negative Rh is preparing for motherhood, she should carefully consider the characteristics of her body. Your other half should also be tested for Rh in order to identify and prevent the development of Rh conflict.