Ngakho, uhlele izinhlelo zokukhulelwa. "Futhi bheka i-rhesus-conflict? "- uyabuza. Abesifazane, njengombuso, bafunde ngakho ngesikhathi sokukhulelwa. Ekubonisaneni kwabesifazane, benza ukuhlolwa kwegazi okunembile, thola iqembu kanye ne-Rh-accessory ngaphambi kwesikhathi. Lolu cwaningo luyadingeka ukukhipha noma ukuvimbela ithuba lokuthuthukisa inqubo ye-pathological, okukhulunywa ngayo ezincwadini zezokwelapha njenge-Rh-impikiswano.
Abantu abangamaphesenti angama-85 ngamaseli abomvu-i-erythrocyte aqukethe i-protein antigen, ibizwa ngokuthi i-Rh factor. Kulezi zingu-85% i-Rh, ngokulandelanayo, kulungile. Amaprotheni asele angu-15% asele abomvu amangqamuzana egazi alahlekile futhi, ekunqumeni iqembu labo legazi, umsizi we-laboratory uzobeka i-rhesus nge-minus.
I-Rhesus-mpikiswano eyaziwayo iqala ukushayisana kwe "plus" futhi "minus" ohlelweni oluvaliwe lomzimba womuntu. Isibonelo, uma umuntu onesi- "igazi elihle" ethulule okungalungile. Noma uma owesifazane onesibonakaliso esincane esithwala isisu, egazini elikhona i-Rh factor. Kuphela kwe-physics, kanye nokunciphisa ukukhanga, ekubelethweni kwemithi kuhlukile. Isimo siqala kabi.
Kanye egazini lalabo abathintekayo bathola amangqamuzana egazi abomvu we-fetus aqukethe i-Rh factor, amangqamuzana awo omzimba omzimba awabona njengabahlasela imizimba yangaphandle. Umzimba uthumela i-alamu bese uqala ukuthuthukisa ama-antibodies okuzivikela. Mane nje, isimiso somzimba sokuzivikela sikamama sibhubhisa amangqamuzana egazi abomvu, aqukethe i-rhesus engaziwa. Izitho ze-hematopoietic ze-fetus ziyasetshenziswa futhi ukuze zigcwalise inani lamaseli abomvu abhubhisayo, ziqala ukuzitholela nge-redoubled force. Lokhu kuhlanganisa ukwanda kwezinga lezinto ezibizwa nge-bilirubin. Ngaphezu kwalokho, ingqondo yengane yesikhathi esizayo ingase ihlupheke. Isibindi nesipelingi, esebenza kwimodi yokwanda komthwalo, ekugcineni, ayikwazi ukubhekana ... I-Fetus ayinakho oksijini. Ezimweni ezinzima kakhulu, kungenzeka ukuthi ngeke zisinde.
Futhi ngemva kokubeletha, lawa bantwana ahlakulela isifo se-hemolytic yengane esanda kuzalwa. Ukuxilongwa kuyadumaza, kodwa kungagwenywa uma izinyathelo zokuzivikela zithathwa ngesikhathi. Ukuqala kudingekile ngokuqapha njalo ochwepheshe.
Ngokuvamile, ukubhaliswa kokubonisana kwabesifazane, owesifazane okhulelwe uthola izinkomba ezimbili ekamelweni lokunakekela ukuthola uhlobo lwegazi ne-Rh factor. Okubili, ngoba ukuhlaziywa kwesibili kufanele kudlule uyise wengane. Lokhu kuzosiza ukubikezela ukuhlukahluka kokukhulelwa. Uma bobabili abazali bane-rhesus efanayo (kungakhathaliseki ukuthi inhle noma ayibi), ngeke kube khona inkinga.
Esikhathini lapho umyeni ane-rhesus engafanele nomkayo, kukhona amathuba aphezulu (75%) okuthuthukisa uhlelo lwe-Rh. Kuyenzeka lapho umntwana ezuza iR Rh uyise kayise.
Kodwa-ke, akudingekile ukuqonda abazali abahlukahlukene be-rhesus njengesigwebo ngesigwebo "sokungabantwana." Kuncike ekutheni ukukhulelwa kwamanje kungokuqala (kwakungabikho ukukhipha isisu kanye nokukhubazeka), amathuba okuba nombambiswano awunjalo. Ngoba ngesikhathi sokukhulelwa kokuqala, ama-antibodies akhiqizwa ngemali encane futhi ayithinti ingane.
Ukuvuselela ukukhiqizwa kwama-antibodies kungase kube negazi lomntwana ozayo owe ohlelweni lomjikelezo lomama nge-placenta emelekile noma enegciwane. Inqubo efanayo kwenzeka ngesikhathi sokubeletha, ukukhulelwa kwesisu nokukhipha isisu.
Ngakho-ke, egazini lowesifazane osevele enesifo sokukhulelwa kwe-rhesus, kukhona okuthiwa "amangqamuzana omemori". Phakathi nokukhulelwa okulandelayo, basabela kumangqamuzana egazi abomvu we-Rh-positive fetus ngokukhiqizwa kwe-antibodies eyingozi.
Yingakho omama abazayo abawela eqenjini eliyingozi kumele babe ngaphansi kokuqondiswa njalo kwesigqila sabesifazane. Phakathi nokukhulelwa konke, kuyodingeka uthathe uhlaziyo olukhethekile olukhomba ukuthi kukhona ama-antibodies egazini. Kuze kube amasonto angu-32 - kanye ngenyanga, esikhathini esizayo - ngesonto ngalinye. Uma umphumela ungalungile futhi ukukhulelwa kuvela ngokujwayelekile, emavikini angu-28 owesifazane uhlinzeka nge-immunoglobulin ephikisayo. Lesi yisilinganiso esibalulekile sokuvimbela, isidakamizwa siyabona futhi sibopha ama-erythrocyte "amacala aqinisekisayo" kumama. Ubenza bangabonakali esimisweni sakhe somzimba omzimba.
Umphumela omuhle wokuhlolwa nge-high antibody's titer iyinkomba yokubeletha ngokushesha owesifazane okhulelwe.
Esikhungweni se-perinatal, izazi zizoqhubeka ziqapha izinga lama-antibodies. Futhi i-ultrasound ku-dynamics izovumela ukuphawula izinguquko ezincane ezingxenyeni zangaphakathi zengane.
Ngokujwayelekile ngaphansi kokulawula ngokucophelela ukukhulelwa kungalethwa ngosuku olufunayo. Isigaba esilandelayo yisigaba se-cearean.
Ngosuku lwesithathu ngemuva kokuzalwa kwengane ene-Rh factor, owesifazane uboniswa ukuphathwa kwe-immunoglobulin ephikisayo. Uzodlala indima ekukhulelweni okulandelayo, ekuvimbeleni ukuthuthukiswa kwe-Rh-impikiswano.
Uma ukukhulelwa kokuqala kwakungapheli, futhi emva kokuzalwa kwakho wanikezwa isidakamizwa esifanele, kungenzeka ukuthi ukuzalwa kwengane yesibili ngeke kubangele ubunzima obukhulu. Amathuba okuthuthukisa i-Rh-ingxabano kuphela ngo-10-15% kuphela.
Kunoma yikuphi, akukho ukuphikisana kokukhulelwa. Kulula nje, isimo sidinga ukuqapha ngokucophelela ochwepheshe kanye nendlela enomthwalo wemfanelo ekusetshenzisweni kwezincomo zabo. Njengoba ubona, izinhlelo kanye nokuphikisana kukaRhesus akuhambisani ngaso sonke isikhathi.