If there is no direct dependence between height titr-antibodies and a degree porazheni... [Архив]

Oshchepkova S.R.

15.06.2004, 07:16

1. The risk of an isoimmunization depends on quantity or amount a rhesus - the positive erythrocytes which have got in a blood of mother. And for an estimation of a status of the woman and the forecast of pregnancy use credit AT in dynamics or changes and some other methods. 2. No.
Otkserokopirovala to you small clause or article about a rhesus - konfldikte.
The immunologic conflict is caused by incompatibility of a blood of mother and a fetus on rezus-to the factor and system AVO owing to what hemolitic illness or disease of a fetus and the newborn develops.
By the nature rezus-the factor is a protein which contains basically in erythrocytes, to a lesser degree - in leucocytes, thrombocytes and other cells of tissues. Rezus-the factor, getting in a blood rezus-the negative person, causes its or his immunization that is shown by development or manufacture antirezus-antibodies. So transfusion rezus-a positive blood rezus-to the negative patient stimulates education of antibodies in 50 % of cases.
In immunization rezus-the negative woman can result or bring intravenous introduction rezus-the positive blood, previous spontaneous or artificial abortions, an extrauterine pregnancy or a salpingocuesis, but more often - pregnancy and labors rezus-a positive fetus, especially at operational interventions: manual unit of a placenta or cesarean section. Rezus-immunizations promote disturbances of integrity vorsin a chorion observed at gestozah, threats of an abortion, infectious and ekstrogenitalnyh diseases as a result of which in a blood flow of mother enough fetalnyh erythrocytes acts.
Immunization at incompatibility of a blood on system AVO is caused by education in a blood of mother of incomplete isoimmune antibodies And and In and their transition through a placenta to a fetus. The most frequent incompatible combination of groups of a blood of mother and a fetus are: 0 (1) - And (2); 0 (1) - In (3); In (3) - And (2); And (2) - In (3).
Proceeding through a placenta rezusnye and group antibodies cause a hemolysis of erythrocytes of a fetus with development of typical displays of hemolitic illness or disease. The hemolysis of erythrocytes is accompanied by education of a plenty of an indirect bilirubin, kotryj is the strong fabric poison or venom resulting or bringing, owing to blockade of ferment or enzymatic systems, to snnizheniju fabric respiration.
The indirect bilirubin almost nerastvorjaetsja in water, exists only in connection with an albumin, and cannot be allocated therefore with urine. As soon as stocks of an albumin are exhausted, the indirect bilirubin passes in the tissues rich with lipids, first of all he in lots or plenties collects in a tissue of a brain that can lead to development of the so-called nuclear icterus leading disturbance of function of hearing, speech, development bilirubinovoj to an encephalopathy.
The indirect bilirubin, acting in hepatic cells, incorporates or is bridged to a glucuronic acid and turns to a direct bilirubin, well soluble in water and deduced or removed kidneys of a fetus. But ability of a liver of a fetus to a conjugation of a bilirubin is limited.
Depending on a degree of development of pathogenetic mechanisms hemolitic illness or disease of a fetus of a various degree of gravity develops.
At izosensibilizatsii women on rezus-to the factor and system AVO it is observed not only a birth of a fetus with attributes of hemolitic illness or disease, but also antenatalnaja destruction of fetuses and a repeated spontaneous abortion. At high activity of antibodies misbirths can come or step in early durations of gestation.
Great value for forecasting pregnancy the estimation has a rhesus of an accessory or a belonging of the husband. If at the father a rhesus a negative blood all children of this pair will have Rh-a negative blood. If at the father a rhesus a positive blood the fetus can be both a rhesus positive, and a rhesus negative. Thus, if the husband has a homozygous type of a blood all children of this married couple will have a rhesus a positive blood and if at the father the heterozygotic type of a blood in 50 % of cases the fetus will be a rhesus positive and in 50 % a rhesus negative is established or installed.
The big diagnostic value or meaning;importance has research rezus-antibodies in a blood of the pregnant woman. At research pay attention to size of an antiserum capacity and on its or his fluctuations during pregnancy. Height of an antiserum capacity at mother and the obstetric anamnesis (......................) help or assist to prognosticate gravity of hemolitic illness or disease of a fetus during pregnancy priblizitelnno in 62 % a case.
At a credit rezus-antibodies 1 : 16 risk of fetal destruction of a fetus reaches or achieves 10 %. Direct dependence between height of an antiserum capacity and a degree of a lesion of the child at hemolitic illness or disease of the newborn is not present. At a low antiserum capacity (1 : 2, 1 : 4) equally often arise both easy or light;mild and serious forms of hemolitic illness or disease of the newborn. At the same time at a high antiserum capacity easy or light;mild forms do not meet. The credit 1 : 32 in the majority of laboratories is considered critical, that is at excess of this value or meaning;importance the opportunity mertvorozhdenija becomes appreciable.
The hemolitic illness or disease of a fetus caused AVO-by incompatibility, develops enough often, however its or her serious forms arise less often. It speaks that N and V-antigens of a fetus to the extremity or end of pregnancy still finally are not generated and have less expressed antigenic activity in comparison with rezus-the factor.