Impact of Immunization Prophylaxis on the Course of Pregnancy in Rh-Negative Women

Abstract

The purpose of the work was to study the characteristics of the course of pregnancy in women who received Rh immunoprophylaxis. Materials and methods. 64 pregnant women were examined, the average age of whom was 30.55 ± 7.0 (18–43) years. Out of 64 pregnant women, 24 (37.5%) were pre-pregnant, 40 (62.5%) were re-pregnant. The somatic and obstetric anamnesis of all pregnant women included in this study was studied. The average number of pregnancies in 40 repeat-bearing women with Rh (-) blood was 2.34 ± 0.6 (1–5). The obtained results of the study were subjected to statistical processing. At the same time, a computer program "Statgraph" was used, designed for statistical data processing in a parametric and nonparametric way. The work was carried out on the basis of the Educational and Surgical Clinic of the Azerbaijan Medical University. Results and discussion. The study of the course of pregnancy in women with no Rh isosensitization made it possible to establish the presence in the first trimester of a high incidence of anemia (27.3%), vomiting and nausea (21.2%), asymptomatic bacteriuria (17.4%), threatened abortions (14.4%). In the second trimester, there was also a high incidence of anemia (28.6%), asymptomatic bacteriuria (21.4%), threatened abortions (15.7%), exacerbation of chronic pyelonephritis (12.9%), mild preeclampsia (10%). In the third trimester, a high frequency of the menace of uterine rupture along the scar was 22.6%, the threat of preterm birth was 18.5%, and acute respiratory viral infection was 16.9%. It was found that the frequency of abdominal delivery was 73.4%, the frequency of the vaginal birth was 26.6%. A study of the condition of newborns made it possible to establish a satisfactory condition in 70%, a moderate condition in 18.8%, and a serious condition in 6.3% of infants. The severity of the condition was determined by the presence of prematurity in 15.6%, weakness of labor and labor stimulation in 6.3%, and the presence of umbilical cord pathology in 6.3%. None of the newborns had clinical and laboratory manifestations of hemolytic disease of the newborn, which reflects the effectiveness of the prevention of Rh isosensitization, the introduction of anti-D immunoglobulin during pregnancy and after childbirth. Conclusion. The use of anti-D immunoglobulin after previous births and at a gestational age of 27.7 ± 0.09 weeks in present pregnancy eliminates isosensitization in pregnant women with Rh-negative blood. Timely prophylaxis of anti-D immunoglobulin prevents the development of hemolytic disease of the newborn in this group of women. The use of anti-D immunoglobulin is of great importance to reduce perinatal morbidity and mortality in pregnant women with Rh-negative blood