Covmestimosty Resurrection in rhesus faktoru play vesomuyu roly at birth zdorovogo rebenka.Gemoliticheskaya bolezny in rhesus conflicting - and danger seryeznoe zabolevanie, vstrechayushteesya at 99% with zhenshtin otritsatelynыm rezusom.
Chto taco rhesus antibodies and how Oni vliyayut of fruit
Rh-antibodies - эto soedineniya belkovoy strukturы, kotorыe vыrabatыvayutsya in materinskom organizations in otvet of popadanie it polozhitelynыh эritrotsitov rhesus fetus (immunnaya system budushtey mamы vosprinimaet эti эritrotsitы how chuzherodnыe). In obnaruzhenii krovotoke in rhesus ma-antibody leech fastened diagnosis: Rhesus sensitization. Эto proishodit in iskusstvennom or samoproizvolynom prerыvanii matochnoy or vnematochnoy beremennosti. Rh-antibodies Mughals poyavitysya takzhe then pervыh generic, esli rozhdennыy rebenok Rhesus positive (st Vremya generic krovy rebenka popadaet in krovotok matter vыzыvaya sootvetstvuyushtuyu reaktsiyu). Rhesus sensitization body otritsatelynoy zhenshtinы vozmozhna takzhe perelivaniyah in rhesus nesovmestimoy Resurrection (even esli Taki cape provodilisy rannem in childhood).
Vtoraya beremennosty Rh-Rh-otritsatelynoy zhenshtinы polozhitelynыm plodom can staty rokovoy dlya budushtego rebenka
Protsess immunizatsii beremennoy zhenshtinы nachinaetsya with currently educated in the rhesus antigen эritrotsitah fetus. Poskolyku antigenы sistemы rhesus soderzhatsya Resurrection in fruit about 7-8 Sundays beremennosti, then nekotorыh sluchayah vozmozhna rannyaya sensitization body matter.Odnako in podavlyayushtem bolyshinstve sluchaev pervaya beremennosty in rhesus otritsatelynoy zhenshtinы (at otsutstvii proshlom sensitization in the body) without protekaet oslozhneniy. Risk developments Rhesus sensitization in vozrastaet posleduyushtih beremennostyah, especially in cases prerыvaniya pervoy beremennosti, krovotecheniy st Vremya pervoy beremennosti in ruchnom otdelenii platsentы and takzhe, esli rodы provodyatsya putem Caesar or sections soprovozhdayutsya znachitelynoy krovopoterey. Эto obayasnyaetsya temperature trust that perechislennыh oslozhneniyah in great quantities veroyatnosty hits bolyshogo rhesus polozhitelynыh эritrotsitov in materinskiy krovotok and how the result - educated bolyshogo quantities rhesus antibodies. Crom Togo in pervoy beremennosti immunnaya system budushtey ma vstrechaetsya with rhesus polozhitelynыmi эritrotsitami vpervыe fetus. Poэtomu Tac antibody vыrabatыvaetsya not much: for example stolyko, skolyko need dlya unichtozheniya postupayushtih in krovy ma эritrotsitov fetus. Crom Togo эti antibodies otnosyatsya k immunoglobulinam klassa M imeyushtim bolyshie razmerы and pleats pronikayushtim out by means platsentu plodu k. Zaton then in generic organizational zhenshtinы ostayutsya "cells pamyati" kotorыe in posleduyushtih beremennostyah sumeyut "organizovaty" bыstruyu and moshtnuyu vыrabotku antibodies against Rh-factor.Эto wake uzhe antibodies inogo types - immunoglobulinы klassa G, kotorыe imeyut menyshie razmerы, Cem immunoglobulinы M and, sledovatelyno, legche pronikayut out by means platsentu and yavlyayutsya agressivnыmi sick. Poэtomu femininity immunnoy sistemы reaction of Rh-antigen in fetal and vtoroy tretyey beremennosti Gorazd bыstree zhestche and, in pervoy Cem. Sootvetstvenno, vыshe and risk damage to the fetus.
In dannыm meditsinskoy literaturы then pervoy beremennosti immunizatsiya voznikaet zhenshtin at 10%.Esli zhenshtina otritsatelynoy with Rh-Rh-krovyyu inevitably immunizatsii then pervoy beremennosti it in sleduyushtey beremennosti rhesus polozhitelynыm plodom veroyatnosty immunizatsii vnovy sostavlyaet 10%.
Zdorovyyu budushtey mamы Rhesus sensitization vredit not, but the lion can predstavlyaty opasnosty dlya rebenka. Popadaya krovotok in fetal rhesus antibodies razrushayut эritrotsitы ego, vыzыvaya anemiyu (decrease gemoglobina) intoksikatsiyu, impaired functioning and the life-vazhnыh Organ System. Taco sostoyanie nazыvaetsya gemoliticheskoy boleznyyu (gemoliz - destruction эritrotsitov).
Raspad эritrotsitov privodit k povrezhdeniyu pochek and golovnogo mozga fetus. Poskolyku эritrotsitы neprerыvno unichtozhayutsya, ego and pecheny selezenka starayutsya uskority vыrabotku New эritrotsitov in эtom uvelichivayasy in size. In con kontsov not spravlyayutsya and Oni. Nastupaet silynoe kislorodnoe golodanie and zapuskaetsya New vitok tyazhelыh disorder rebenka organizations. In samыh tyazhelыh sluchayah эto zakanchivaetsya ego vnutriutrobnoy gibelyyu of razlichnыh beremennosti period, in sickness legkih - Rhesus conflict proyavlyaetsya then zheltuhoy birthday or anemiey novorozhdennogo.
Rebenok can roditysya with fiziologicheskoy zheltuhoy. Reason ff vozniknoveniya - in immature fermentov roasted kotorыe aktiviziruyutsya in nedonoshennыh child lishy co vtoroy - tretyey birthday last Sunday.Togda and proishodit "samolikvidatsiya" эtogo kind of tender. How rule fiziologicheskaya zheltuha not okazыvaet otritsatelynogo vozdeystviya of rebenka: net increases and roasted selezenki, otsutstvuet anemia.
Razlichayut three formы gemoliticheskoy novorozhdennыh of tender: otechnuyu, zheltushnuyu, anemicheskuyu.
Otechnaya | Naibolee tyazhelaya and harakterizuetsya obshtim otekom at birth, nakopleniem zhidkosti in polostyah (legochnoy, serdechnoy sumke, bryushnoy polo) with sharpness blednostyyu zheltiznoy, uvelicheniem roasted selezenki. Analysis Resurrection pokazыvaet rezkuyu anemiyu (malokrovie).Sochetanie sharpness and anemia nizkogo urovnya marten in Resurrection rebenka sposobstvuet razvitiyu serdechnoy nedostatochnosti, kotoraya can salutations k letalynomu ishodu (vnutriutrobno srazu or later birthday).
Zheltushnaya form | Shammai chastaya klinicheskaya form.
Rebenok obыchno within rozhdaetsya with normalynoy massoy bodies without vidimыh change color skins.Uzhe 1-2 sutki viability poyavlyaetsya zheltuha, kotoraya bыstro narastaet. Proishodit increase and roasted selezenki, nablyudaetsya nebolyshaya otechnosty tkaney. Deti vyalыe, adinamichnыe, pleats Sosua.Refleksы snizhenы. Vыrazhena anemia sharp uvelichivaetsya soderzhanie bilirubin Resurrection. Mocha temnaya, mud obыchnoy colors. Bilirubinovaya intoxication harakterizuetsya vyalostyyu, srыgivaniyami, rvotoy, pathological zevaniem, snizheniem mыshechnogo tone. Zatem Mughals poyavitysya sign bilirubinovoy intoxication mozga - "yadernoy zheltuhi": rigidnosty zatыlochnыh mыshts, rezkiy, "mozgovoy" jack, vыbuhanie bolyshogo rodnichka, podergivanie mыshts, sudorogi, dыhaniya violations. In pozdno nachatom and nepravilynom lechenii in posleduyushtem vozmozhno vыyavlenie priznakov detskogo tserebralynogo paralysis, zaderzhka psihofizicheskogo developments, deafness, impaired speech.
Anemicheskaya form | Naibolee legkaya, vstrechaetsya in 10-15% and sluchaev proyavlyaetsya blednostyyu, pleats appetitom, vyalostyyu, roasted and uvelicheniem selezenki, anemiey, umerennыm povыsheniem bilirubin.
Gemoliticheskaya bolezny novorozhdennыh in nesovmestimosti in sisteme protekaet neskolyko legche ABO, Rh-Cem in conflict. But Mom esli zaboleet a period beremennosti, vozmozhno povыshenie platsentarnogo baryera permeability, k kotoroe privodit formirovaniyu sick tyazhelыh gemoliticheskoy form of tender. With tselyyu dorodovoy diagnosis opredelyayut uroveny bilirubin okoloplodnыh water kontsentratsiyu rhesus antibodies.
Chto delaty, esli in Resurrection beremennoy zhenshtinы obnaruzhenы rhesus antibodies
However beremennыe with rhesus otritsatelynoy krovyyu dolzhnы obsledovatysya regular presence of Rh-antibodies in sыvorotke Resurrection and in this case I'd obnaruzheniya nahoditysya nablyudeniem below.
If necessary provoditsya osnovnoe the healing event - vnutriutrobnoe perelivanie Resurrection (below kontrolem out by means of ultrasound perednyuyu bryushnuyu stenku ma pronikayut in venules and pupovinы perelivayut plodu эritrotsitarnoy massы 20-50 ml).
At bolyshinstva people in эritrotsitah soderzhitsya osoboe substance (antigen) kotoroe vpervыe bыlo obnaruzheno in Resurrection obezyyan porodы rhesus macaque monkeys, in svyazi with Cem ego names rhesus faktorom.
Эta operation snizhaet amounts of antibodies to 75% and pozvolyaet prodlity beremennosty. Praktikuetsya stimulyatsiya prezhdevremennыh generic, then kotoraya proizvoditsya legkih formations and early in the period 35-37 nedely. Rodы takzhe vыzыvayutsya, esli plodu ugrozhaet opasnosty.
Sovremennыe metodы treatments
Chashte vsego gemoliticheskaya bolezny bыstro razvivaetsya at last birthday rebenka namely, chemu sposobstvuet postuplenie bolyshogo amounts of antibodies in krovy babes in narushenii sosudov platsentы integrity.
Treatment of tender gemoliticheskoy complexity, complexity, inogda malыshu trebuetsya zamennoe perelivanie Resurrection. Vrach vvodyat emu rhesus otritsatelynuyu krovy gruppы ego and sent reanimatsionnыe events. Эtu operatsiyu osushtestvity necessary within 36 hours then poyavleniya rebenka the world.
How izbezhaty poyavleniya rhesus antibodies
Vazhnaya roly prophylaxis in Rhesus sensitization otvoditsya planirovaniyu semyi and svoevremennomu testirovaniyu. Garantiey birthday zdorovogo rebenka in rhesus otritsatelynoy zhenshtinы (at otsutstvii predshestvuyushtey sensitization perelivaniyah crowns) yavlyaetsya sohranenie pervoy beremennosti.
Dlya definitions in Resurrection antibody k krasnыm krovyanыm cell delaetsya Coombs test. With tselyyu preventive Rh-sensitization vvoditsya antirezus-gamma-globulin (RhIG) the term in 28 nedely beremennosti and pozdnee, Cem out by means of 72 hours then generic. Immunoglobulin svyazыvaet ostavshiesya then generic krovotoke in rhesus ma-polozhitelynыe эritrotsitы fetus does not samыm temperature zapustitysya Owned materinskomu immunnomu otvetu (vыrabotke materinskih protivorezusnыh antibodies). Vvodity ego needed then generic, esli rodilsya rhesus polozhitelynыy rebenok, then iskusstvennogo or samoproizvolynogo prerыvaniya beremennosti, then operations in proizvedennoy svyazi with vnematochnoy beremennostyyu.
Irina Sap
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