I-Rhesus factor (i-D-antigen) iprotheni ethile ephezulu kumaseli obomvu (amangqamuzana egazi abomvu - iiseli zegazi ezizisa i-oksijini kwiimfucu). Abantu abanalo protheyini abakhona kwiiseli ezibomvu zegazi, ngokulandelanayo, baRh-positive (malunga ne-85% yabantu). Ukuba le protein ayikho, igazi leloo mntu libizwa ngokuba yi-Rh-negative (10-15% yabemi). I-Rhesus ingeyomntwana ebusweni kwiindawo zokuqala zokukhulelwa. Ngokwalo, i-Rh engathandekiyo ayifaki ingozi kubantu. Le yinto enye yempawu yomzimba. Ubuqhetseba bakhe, unokubonakalisa ngexesha lokukhulelwa komama ozayo weR Rh-negative.
Iqela leengozi.
Iquka imimoni enegazi elingenayo i-Rh, abayeni bayo bathwala i-Rh efanelekileyo. Kule meko, umntwana wabo unokufumana ilifa le-Rh (elinamandla) ukusuka kubaba. Kwaye kukho i-rhesus-conflict, okanye ukungalingani ngegazi phakathi komama kunye nomntwana. Ngesiqhamo "esingathandekiyo" somama "ongathandekiyo" wongquzulwano akayi kuvela. Kwezinye iimeko, ingquzulwano iyenzeka xa ibhinqa, umzekelo, mna uhlobo lwegazi, kunye nosana - II okanye III. Nangona kunjalo, ukungahambelani kweqela legazi akuyona ingozi njengoko ku-Rh factor.
Kutheni i ngxabano?
Makhe sibone isizathu sokuba kukho inkxalabo yokukhulelwa njengoko i-Rh-conflict? Ngethuba lokukhulelwa, i-erythrocytes ene-Rh inxalenye ye "fetus positive" ingena egazini lomama "ongekho". I-Rhesus-positive blood of the baby is for "negative" body of mother by protein alien (strong antigen). Kwaye umzimba womama uqala ukuvelisa iiseli ezikhethekileyo-antibodies kwi-Rh factor, oku kuthetha ukuba umzimba womntwana. Azinabungozi kubasetyhini, kodwa zichitha iiseli ezibomvu zegazi elingakazalwa.
Ingozi kumntwana!
Ukungqubuzana - i-hemolysis ye-erythrocytes ikhokelela ekuphuhlisweni kwezifo ze-hemolytic ze-fetus, oku kubangela ukulimala ezintsheni kunye nengqondo, i-anemia ikhula. Ukuba iiseli ezibomvu zegazi zihlala zitshabalaliswa, isibindi kunye neengeni zizama ukuzalisa ukugcina kwazo kunye nokwandisa ubungakanani. Iimpawu eziphambili zezifo ze-hemolytic ze-fetus ziyanda kwi-isibindi kunye ne-spleen kuyo, echongwa ngu-ultrasound. Kwakhona, inani elinyukayo le-amniotic fluid kunye ne-placenta eqinisiweyo yimiqondiso yesifo se-hemolytic yomntwana. Kule meko, umntwana uzalelwe ngamaseli egazi abomvu abonakalisiweyo, anemia. Emva kokuzalwa kuka-anti-mother's blood in the blood of the baby, baqhubeka ixesha elihle umphumo wabo owonakalisayo. Umntwana une-hemolytic anemia ne-jaundice. Kukho iintlobo ezintathu zeekliniki zezifo ze-hemolytic ezisandulweyo:
Ifomu yeJaundice yifom yeekliniki eqhelekileyo. Umntwana uvame ukuzalwa ngexesha, ngesisindo somzimba esifanelekileyo, engabonakaliyo ngokubonakalayo kwesikhumba. Sekude ngomhla woku-1 okanye wesi-2 wobomi kukho i-jaundice, ekhula ngokukhawuleza. Umbala obomvu kwaye ube ne-amniotic yamanzi kunye neyayilisi yokuqala. Kukho ukwanda kwintsholongwane kunye neengqungquthela, kukho ukuvuvukala kwamathambo.
Ifom ye-Anemic iyona enobunzima kakhulu, ivela kwi-10-15% yamatyala kwaye ibonakaliswa yi-pallor, isondlo esingasondelanga, ukunyaniseka, isibindi esandisiweyo kunye ne-spleen, i-anemia, ukwanda kwe-bilirubin.
Uhlobo oluhle lwesifo se- hemolytic yinto ephakamileyo. Ngemfazwe yokuqala ye-immunological, ukuphuphuma kwesisu kungahle kwenzeke. Ukuba ukukhulelwa kunokudluliselwa ekupheleni, umntwana uzalwa ene-anemia ephezulu, i-hypoxia, izifo ezibangelwa ngumzimba, i-edema yamathambo kunye nokungaqiniseki kwe-cardiopulmonary.
Ukuphuhliswa kwesifo se-hemolytic akusoloko kugqitywa ngongxowankulu lwe-anti-body antibodies (kwiiyo, i-antibodies) yayo kumama. Ubunzima bokukhula komzimba olusandul 'ukuzalwa lubalulekile: isifo sinzulu nakakhulu kwiintsana ezingaphambi kwexesha.
Isifo se-Hemolytic yeintsana ezinokungahambelani ngokwemiqathango ye-ABO ihamba ngokulula kunokuba i-Rhesus-impi. Kodwa ngenxa yezifo zomama ngexesha lokukhulelwa, ukwanda kwe-permmeability ye-barrier barrier can occur and then the form of severe forms of hemolytic disease can occur.
Ukukhulelwa kokuqala kukhuselekile
Ukuba inani elithile legazi "elihle" lingena emzimbeni womama "ongenanto", ngoko kuphela umzimba wakhe uqala ukuvelisa izifo zengqungquthela. Kukhona ukukhunjulwa komzimba kamama, njengokungathi "ukucaphuka". Kwaye le "ngcikivo" ngexesha ngalinye, oko kukuthi, ngokukhulelwa konke, kwanda. Ngoko ke, kwiimeko ezininzi, ukukhulelwa kokuqala kunye nomntwana "olungileyo" wokuba "ungekho" unina uhamba ngokungafunekanga. Ngokukhulelwa okulandelayo, umngcipheko wokuphuhlisa umxhatshazo we-Rh unyuke kakhulu. Ngako oko, kubaluleke kakhulu ukuchazela "umfazi" ongenalo umphumo wokukhupha isisu ekukhulelweni kwakhe okulandelayo. Ziyandisa ngokukhawuleza umngcipheko we-Rhesus-conflict.
Sinikezela ngokuhlalutya.
Nangona ingxabano yeRhesus yinkxalabo yokukhulelwa, kodwa njengoko sele sifumene, umntwana kuphela ohluphekayo. Ngoko ke, ukugweba ubunzima beli ngxabano kwimeko yowesifazane okhulelweyo akaqondi. Umama ozayo unokuziva ukhululekile, ube nesondlo esihle kunye nempilo entle. Ukuhlalutya kubaluleke kakhulu kule meko. Xa owesifazane okhulelweyo ebhaliswe kwiklinikhi yomfazi, into yokuqala ayenzayo ibeka iqela legazi kunye neRher. Ukuba kuvela ukuba umama wexesha elizayo ungu-Rh-negative, ngoko ke unikezelwa uhlalutyo lobukho be-antibodies. Ukuba iimpawu zengqungquthela azifumaneki, kufuneka zithathele olu hlalutyo nyanga zonke, ngenxa yokubona kwabo ngexesha elifanelekileyo. Ukuba i-antibodies ifunyenwe, iinjongomzimba zowesifazane okhulelweyo kufuneka zivavanywe rhoqo. Ngokutsho kwabo, ugqirha ugqiba i-anti-titer titer, oko kukuthi, ukugxininiswa kwegazi, kwakhona uyaphawula ukuba kukho ukuthambekela kokunyusa kunye nexesha. Ukuba i-antibody titer yanda, umfazi okhulelweyo ukhuselwe kwisifo se-hemolytic yomntwana. Eli bhinqa lijojowe ne-antiresus-gamma-globulin kunye nezinye iziyobisi ezincedisa ukunciphisa ukwakheka kwamagciwane.
Umama ubisi obuninzi.
Ngaphambili kwakufundwa ukuba ibhinqa elinesigqirha saseRh ngexesha lokukhulelwa alikwazi ukuncelisa umntwana wayo, kuba izifo zengqungquthela ziqulethwe ngobisi lwebele kwaye zandisa imeko yentsana "enhle". Oku akunjalo ngokuchanekileyo. Enyanisweni, akunakwenzeka ukuncelisa isifuba iiveki ezimbini umfazi owayenengxabano yaseRh kunye nosana lwazalwa ngeesifo se-hemolytic. Abanye oomama, ababenomdlavuza ngexesha lokukhulelwa, kodwa umntwana wazalwa enempilo, angalondla umntwana ngobisi lwebele, kodwa kuqala ajobe i-gamma globulin.
Tune kwizinto ezilungileyo.
Ngokwezibalo, kuphela kwi-8% yamatyala, umama ongenakuma-R angaba ne-Rh-positive baby. Kwaye uninzi lwabafazi abano-Rh abangenayo kwaye bazala abantwana abathathu nabantwana abathathu abanezempilo. Kwaye kuphela i-0.9% yabasetyhini abakhulelweyo bahlakulela ingxaki yokukhulelwa - i-Rhesus-conflict. Ngoko, musa ukuzilungelelanisa iingxaki, ukuba ufumene ukuba unayo igazi elingenalo igazi. Ukuba ulandela zonke iziphakamiso ze-gynecologist yakho, vavanya ixesha, kwaye umngcipheko weengxaki kwi-Rhesus-negative mother kunye ne-Rh-positive yakhe umntwana yancinci.