Rhesus kongquzulwano unina kunye olungekazalwa ngethuba lokukhulelwa: itafile. ungquzulwano omzimba zikamama olungekazalwa

On ukukhulelwa abachatshazelwa zizinto ezininzi. ubungozi High uthwala umama RH-ungquzulwano kunye engekazalwa. Noko ke, asingabo bonke uyayiqonda izizathu ezazibangela le meko, nto leyo ebangela ukoyika ezingaziwayo. Ngoko ke, ukuze nazi ukuba kuyingozi i RH factor yaye xa kukho RH-impixano "Umama-umbungu 'unyanzelekile yonke sikanina.

ungquzulwano Rhesus - ntoni na?

Ukuze siqonde uhlobo ingxaki, kubalulekile kuqala ukuqonda ukuba zibaluleke kangakanani na RH factor. It is a iproteni ethile, ibekwe phezu erythrocyte. Le protein ekhoyo egazini 85% yabo bonke abantu, baze abanye engekhoyo. Ngoko ke, ukuba abanini yokuqala yabo ingqalelo into Rhesus HIV kunye navumelanayo yesibini.

Ngenxa yoko, umisela iimpawu ngumzimba yento ephilayo kunye ngokupheleleyo akukho siphumo empilweni yoluntu. RH into unako kutyunjwe H. + ne Rh-. Kuba okokuqala kule kota elaqanjwa 1940 zizazinzulu kunye Aleksandrom Vinerom Karlom Landshteynerom. RH ingxabano unina kunye umbungu lo ngumzimba igazi ukungavumelani RH kwimeko ukuba unina ezingakhiyo engekazalwa HIV. Ingozi Rhesus-ungquzulwano silele yokuba kunokubangela ukufa ezingekazalwa, ifile, kwezisu. Lo mkhwa zingavela negative-RH unina elizayo kwinkqubo yokumitha ngexesha zabasebenzi. unina omzimba nongquzulwano ungakanani esizibonakalisa xa le mveku sele ilifa H. + uyise.

Oonobangela RH-ungquzulwano unina umbungu

Ngokuba umzimba negazi usana unina elizayo kunye H. + kukho isoyikiso kakhulu, ngoko ukhupha izilwa ukuba i modem ayisebenzi iiseli foetal abomvu ubatshabalalise. Rhesus kongquzulwano unina kunye umbungu wachaza transplantsentarnym ungekafiki owama iiseli foetal ezibomvu kunye RH into entle egazini oomama kunye lwesalathisi ezimbi.

ungquzulwano ngumzimba kubangelwe ikakhulu kwisiphumo ukukhulelwa yokuqala. Ngexesha sokukhulelwa Rhesus kongquzulwano inokuba ngenxa gazi apho RH into ayikho kuthathelwa ingqalelo, izisu zangaphambili, kwezisu. Kwakhona RH igazi engahambelaniyo unako ukungena umntwana emzimbeni kamama ngethuba lokubeleka, ngoko umzimba sikanina uba basengozini a negative RH into, kwaye amathuba RH-impixano ngexesha lokukhulelwa yesibini landa. It kwandisa umngcipheko isoimmunization ngexesha kwicandelo ngoqhaqho. ukungavumelani igazi ukumqumbisa ukopha ngexesha lokukhulelwa nokuzala ngenxa yomonakalo ngumkhaya.

Amathuba RH ingxabano lwegazi

RH isici zemfuza uzimisele kwaye lubalaseleyo phawu ilifa. Ukuba umama a RH elibi, uyise xa homozygosity yi-HIV, umntwana usoloko ufumana RH +. Kulo mzekelo, umngcipheko wokungquzulana yeqela blood uphezulu kakhulu. Kwaye kwimeko yooyise heterozygosity okuba yokudlulisela kwimveku RH negative okanye positive ulwandiso.

Kwi kwiveki wesibhozo lophuhliso ezingekazalwa kukho igazi, apho iiseli ezibomvu ngezinga eliphezulu lilonke ezibanjwa emzimbeni sikanina. Kule khuselo Uhambo lwangaphesheya omzimba oomama njengoko iantigens ezingekazalwa kugqalwa amazwe. Ngoko ke, umzimba uvelisa a omzimba abakhulelweyo RH, nto leyo ebangela ukuba RH impixano unina kunye engekazalwa. Umngcipheko ungquzulwano ngumzimba lincinane ngokwaneleyo ngexesha yokumitha yi 0.8% kuphela, kodwa kuyingozi kakhulu, ngoko ke kufuna ukufunda ezizodwa kunye nengqalelo. Ityhila ntoni igazi iimvavanyo umntwana RH ongekazalwa kwi iqela abazali siyakuvumela okubonisa RH-ungquzulwano lokukhulelwa. Le tafile ibonisa ngokucacileyo amathuba ukungavumelani kwegazi.

Imiphumela nezoyikiso neengxabano rhesus ngexesha lokukhulelwa

unina omzimba nongquzulwano umbungu naxa ingumbandela ozaliswe ziziphumo emibi umntwana. Le awakwazi eziveliswa umzimba ngunina, ukufumana umzimba langaphandle zingaphawulwa RH factor agqobhoza igazi ukuhamba ezingekazalwa ngokusebenzisa njengomqobo kwaye gematoplatsentarny ukuphazamisa hematopoiesis inkqubo yomntwana, ziyibuyisela ukuyilwa iiseli ezibomvu zegazi.

Oku antibodies ukuziphatha kunokubangela imeko yingozi ndingekazalwa, ezisongela ubomi bomntwana, nto leyo luphawulwa asidi, hypoxia, igazi. Xa umzimba usana oluhlala izixa ngokugqithiseleyo kolwelo kwaye lunyhasho phantse onke amalungu kunye neenkqubo. Xa kunjalo, ukuba manyathelo zithathwa ngexesha elifanelekileyo, kukho kakhulu umngcipheko kwesisu, ukufa ezingekazalwa, ifile, ukuzalwa komntwana kunye nesifo hemolytic eziya kuqhubeka ukwenza inkqubela ngenxa sokuzuza umzimba imveliso baby antirhesus omzimba okubangele ungquzulwano unina kunye Umbungu ngexesha lokukhulelwa . Inokubangela uphuhliso izifo, leyo zibonakaliswa kukwanda kwabantwana okungaphaya enyama yangaphakathi, ingqondo, intliziyo, sisilonda esidumbileyoesingaphakathi eyityhefu kwinkqubo luvo.

iimpawu

RH ingxabano unina kunye mbungu ngexesha lokukhulelwa akukho mpawu zonyango kunye neempawu ezithile. Unako ukuchonga ingxaki kuphela beyaleza kwegazi, nto leyo ibonisa ubukho antibodies ezimbi-RH le.

Xa ukungavumelani igazi ezingekazalwa esizibonakalisa kuphuhliso isifo hemolytic le amalungu angaphakathi kunye neenkqubo zomzimba, nto leyo enokukhokelela kwintshabalalo yayo ngexesha ukususela kwiiveki 20-30 zokukhulelwa, kwakunye ukuvela kwesisu, ifile, ukunikezelwa kwexesha.

Ukongeza, umntwana ngokupheleleyo-binzana kubonakala ifomu edematous, icteric kunye zobuthathaka begazi lakho sifo hemolytic. Rhesus kongquzulwano livela kwi osadaleka igazi imbonakalo ubuntwana ezimbi iseli ebomvu igazi nezibilini. Symptomatology ibangwa ubungakanani asegazini ngumama yomzimba. Ngendlela kakhulu zesi sifo lwenzeka xa ekweneni olungekazalwa - kukho ukwanda ubungakanani enyama yangaphakathi, xa kukuvela ngumkhaya ukwanda ascites kunye nomthamo amniotic fluid. ubunzima bomntwana kaThixo kwandiswa ukuya izihlandlo ezimbini, esi sifo soloko ilandelwa yi nokudumba.

uphando laboratory

Rhesus-ingxabano "Umama-umbungu 'ngexesha lokukhulelwa na ukuthintela isigulo kwangethuba, ingakumbi ngokohlobo yokuqaphela uyise RH factor kunye nonina phambi kokuba ukukhulelwa elandelayo okanye ngaphambili ngokwemimiselo yayo.

Ipredikshini ungquzulwano Rhesus isekelwe kwidatha ukutofelwa igazi odlulileyo, ukuhamba kunye isiphumo ukukhulelwa yokuqala, ukufumaneka isisu, kwesisu, ukufa ezingekazalwa ngaphakathi esizalweni sonina, isifo hemolytic komntwana, iyenza ngendlela ethembekileyo ukuchonga amathuba ingozi isoimmunization.

iimvavanyo zegazi Laboratory ukumisela imizimba antirhesus kunye neziqu ziqhutywa kuba bonke abantu ababhinqileyo kunye kuyakrokreleka RH-ungquzulwano lokukhulelwa. Analyses kufuneka athathe uyise womntwana. Ukuba amathuba RH-impixano liphezulu, abasetyhini abakhulelweyo kufuneka avavanywe nyanga zonke. Kwi iveki th 32 nemvavanyo zaselaborathri zenziwa ngaphandle kabini ngenyanga, ngomhla 36 - veki nganye de ukunikezelwa. Ukuba kubonakele RH-impixano lokukhulelwa, esi sifundo liya kuqinisekisa ukuba okuqulethwe antibodies emzimbeni sikanina. Le ngezifo ngaphambili kwafunyaniswa, inowuthi ubungozi iingxaki, njengoko isiphumo RH-ungquzulwano oluhlala phezu kwexesha.

Ultrasound kunye neendlela invasive test uvavanyo lomngcipheko kwimveku

Ukuxilonga ungquzulwano ngumzimba zikamama Umbungu ngokweenkcukacha, ithwalelwe ultrasound amaxesha ubuncinane ezine ukusukela kwiiveki ezingama-20 ukuya ku-36 zokukhulelwa kunye phambi kokuba unikezelo. Ultrasound ikuvumela ukuba ukulandelela iimpawu ndingekazalwa, kwakunye ukuchonga ubukho ezingaqhelekanga.

Uphononongo oluvavanya imeko kunye nobungakanani ngumkhaya, umthamo esiswini ezingekazalwa, fluid, yegazi imfesane yosana.

iindlela ezongezelelweyo kophando i electrocardiogram, cardiotocography, phonocardiography ezivumela mbungu ukuqinisekisa inqanaba hypoxia kungquzulwano rhesus. Abonelela ngolwazi oluxabisekileyo yovavanyo invasive - isifundo kolwelo fluid yi amniocentesis negazi imfesane yosana yi cordocentesis. Uxilongo lwe fluid ukumisela imizimba titer antirhesus, sex wosana, foetal ukuvuthwa semiphunga. I degree ngqo lwesifo axilonge kardotsentoza lwegazi kunye RH factor in foetal egazini intambo. Ukongeza, uphononongo lubonisa ubukho okuneproteni Live Hotmail, ihemoglobin, yibilirubin, reticulocytes, izilwa-buhlungu, zimiliselwe erythrocytes.

unyango

Ukuba kukho ungquzulwano ibanjiwe unina kunye neqela igazi ezingekazalwa, ifana zodwa ezilunyango olusebenzayo igazi eli olungekazalwa ngenxa iphuma yosana ngaphakathi esizalweni. Lenquba yenzelwa phantsi kolawulo ultrasound. Lo mlinganiselo ivumela ukunciphisa imeko ndingekazalwa, kuyolula ukukhulelwa, ukunciphisa iimpawu igazi, hypoxia.

Ukunciphisa iimpembelelo RH ungquzulwano ioksijini unyango kwakhona lwenziwa rate unyango nonspecific, equka iivithamini, amalungiselelo ezinomthamo yentsimbi, calcium, antihistamines abelwe. Ukuba umbungu emsebenzini imeko kakhulu, ngoqhaqho olwenziwa kwiiveki 37-38 zokukhulelwa. Kwakhona, abasetyhini abakhulelweyo elawulwa plasmapheresis, leyo kunciphisa umxholo antibodies ezisegazini iiseli ezibomvu yosana olungekazalwa.

Emva kokuzalwa kosana eyenziwa kotofelo ababambeleyo endaweni erythrocytes eyaphukileyo ukumisela izifo hemolytic - isibeki eziphumela izinto eziyityhefu emzimbeni kwaye yehlise erythrocyte ukubola, zokukhanya kunye yelanga eyingozi. Unyango ifuna ikhosi olunzulu unyango, neonatologists esweni, maxa wambi umntwana ibekwe iyunithi labagula kakhulu. Ukutyisa usana ngobisi lwebele akukhuthazwa ngethuba leeveki ezi-2 zokuqala emva kokuzalwa kwimeko sifo hemolytic.

General neengxabano Rhesus

Isikakhulu isiphumo ukukhulelwa phambi RH-nempixano - ukuzalwa kwexesha. Ngoko ke, lo msebenzi koogqirha sisongezelelo ngokuzala, esweni ebanzi yenkqubo yayo yophuhliso. Kuba wokuhlola ngexesha lonke lokukhulelwa bamthwala ultrasound, Doppler, CTG. Ukuba olunye lisiko yingozi enkulu ukuya kwimveku, isigqibo ukuzalwa ngaphambi kwexesha.

Kwiimeko ezininzi, xa nokuzala ungquzulwano Rhesus iphela icandelo ngoqhaqho. Nokuzalwa ngokwemvelo ezinqabileyo kakhulu kwaye kuphela xa imeko ezingekazalwa iyanelisa kwaye ubomi sana ayikho ingozi. Uqhaqho kubhekwa ekhuselekileyo kakhulu kwaye ukuba nokuthantamisa kubantu olungekazalwa. Ngexesha ukuzala kufuna ubukho neonatologists ukuba enze yokurhaxwa xa kuyimfuneko. Inzala kufuneka kwenziwe kakuhle baxhotyiswa zonke izixhobo eziyimfuneko zonyango kunye indawo phantsi kweliso oogqirha abafanelekayo kakhulu.

amanyathelo othintelo

Ungquzulwano "Umama-umbungu 'ngexesha ukhulelwe kunokubangela neziphumo ezibi kakhulu kubo umntwana. Ngoko ke, kubaluleke amanyathelo ezinkulu othintelo ejolise kuthintelo RH-ungquzulwano kunye nophuhliso isoimmunization. Xa ukutofelwa igazi kubalulekile ukuqwalasela ukuhambisana kunye donor, kuyimfuneko ukugcina ukukhulelwa yokuqala, kodwa ukunqanda izisu. Okubaluleke ngokulinganayo isicwangciso ngenyameko ukukhulelwa. Uphononongo lwamaqela igazi, RH into iya kuthintela RH-ungquzulwano lokukhulelwa. Table iqela igazi ehambelanayo ukuthintela iingxaki kwixesha elizayo. Kufuneka mazilibazele ikhondo yokukhulelwa. Njengoko prophylaxis kusetyenziswa isitofu intramuscular of RH immunoglobulin ayithabathe kwabazana igazi amabhinqa ezimbi-RH kunye nokwanda susceptibility ukuya iantigens positive. Le ukulungiselela uyayonakalisa iiseli ezibomvu ukuba lentsholongwane ukusuka carrier RH into, oku kunciphisa amathuba isoimmunization kunye RH ungquzulwano.

Izitofu yenziwa emva kokupheliswa ukukhulelwa, kwesisu, utyando intrauterine ukuthintela ukukhulelwa. Kwakhona, RH globulin omzimba yenziwa abasetyhini abakhulelweyo ngoweqela Lendlela Yeqela umngcipheko kwi kwiiveki 28 kwakhona kwi 34 ukunciphisa amathuba nophuhliso isifo hemolytic yosana olungekazalwa. Kwakunye isitofu ibhalwa kwiintsuku 2-3 emva kokuzalwa, oku kunciphisa amathuba Rhesus-ungquzulwano zokukhulelwa ezilandelayo. Immunoglobulin ilawulwa kunye nokukhulelwa ngalinye, ukuba amathuba okufumana umntwana kunye RH into entle.

Ngenxa yoko, unina RH-impixano kunye engekazalwa akukho ngunobangela sokupheliswa yokukhulelwa. Amathuba yokuphuhlisa Rhesus impixano incinane kakhulu, ngoko akukho sizathu lithemba. Ngenxa phambili mihla zizifo apho kusoloko nako ukusebenzisa usana womelele kwaye usempilweni.