Human anti-rhesus immunoglobulin. Anti-Rhesus immunoglobulin against Rh-conflict. Interaction with other medicinal products

Content

Rh-conflict entails serious health problems for the unborn baby, therefore, it is necessary to respond in a timely manner to the presence of such a pathology. The introduction of the drug during pregnancy increases the chances of the fetus for viability, reduces the list of potential complications in the prenatal period. The pathology is serious, therefore, a woman is under strict medical supervision when carrying a fetus.

What is Rh conflict during pregnancy

If a woman has negative rhesus-factor, she falls into the risk group. For her health, such a feature of the body does not have a negative effect, problems arise during pregnancy. If the fetus has a positive Rh factor, the Rh conflict develops. This means that the mother's immune system is not yet recognizing the cells. born child, as alien, and begins an active struggle with them.

The immunity of a pregnant woman develops antibodies-immunoglobulins to such structures, which, penetrating through placental barrier, massively destroy proteins that are not in the morphological composition of the mother's blood. As a result, jaundice develops in newborns, associated with the breakdown of blood cells (hemolysis). More serious pathologies are not excluded, among them - dropsy of the fetus, damage to the brain and heart, stillbirth. To avoid such complications, the patient must be administered anti-rhesus immunoglobulin during pregnancy.

When anti-rhesus immunoglobulin is needed

For birth healthy child and the exclusion of Rh-conflict, a specific protein is administered to pregnant women with negative rhesus factor... Among other medical indications for the introduction of anti-Rh immunoglobulin in the absence of the Rh factor, doctors distinguish:

  • spontaneous or intentional termination of pregnancy (abortion);
  • trauma abdominal cavity;
  • the threat of termination of pregnancy at any time;
  • after amniocentesis;
  • placental abruption;
  • pregnancy with the further birth of a child with a positive Rh factor;
  • ectopic pregnancy.

How does anti-rhesus immunoglobulin work?

The specified protein is isolated from the serum or plasma of donors who have been preliminary tested for the absence of antibodies to HIV, hepatitis B and C in the blood. When administered, the substance prevents the formation of antibodies to the Rh factor, prevents hemolysis of erythrocytes in the fetus. At the discretion of the attending physician, anti-rhesus immunoglobulin should be administered at 28 obstetric week, but in this case, the likelihood of mixing of two bloods significantly increases even before childbirth.

The optimal period for introducing protein is immediately after the birth of the baby. it effective prevention hemolytic disease during the next pregnancy. If sensitization is detected (the presence of antibodies to the Rh factor in the blood of the expectant mother) and a positive Rh factor, the use of anti-Rh immunoglobulin is categorically contraindicated, it is not urgently needed.

Instructions for the use of anti-rhesus immunoglobulin

A single dosage of the indicated medicinal product is determined individually, intravenous administration of serum is completely excluded. V detailed instructions the application reflects such valuable information for patients at risk:

  1. Serum should be administered intramuscularly, self-medication is categorically contraindicated.
  2. Before injecting the drug, it is necessary to keep it at room temperature for at least 2 hours (warm it up under natural conditions).
  3. For the drug to enter the body, it is necessary to use a disposable sterile syringe with a wide lumen.
  4. When performing an abortion operation, the serum must be injected immediately after its completion.
  5. In the prenatal period, the recommended dose must be implemented at 28 obstetric week - once, then immediately after childbirth.
  6. A single dose after a successful delivery is 300 or 600 mcg of serum, and it should enter the body of a new mother in the first 48-72 hours.

Contraindications and side effects

This medical drug completely eliminates the risk of drug interaction, therefore, it is allowed to enter it even with prolonged antibiotic treatment. But after receiving a single dose of immunoglobulin in female body doctors do not exclude the occurrence side effects... Among those:

  • allergies, skin reactions such as urticaria, severe itching, burning, rashes and flushing skin, less often - acute anaphylactic shock;
  • hyperthymia (instability of the nervous system, represented by an unexpectedly elevated mood, excessive activity in all areas of life);
  • tangible violations by digestive system, for example, pronounced signs of dyspepsia.

The introduction of this important component into the blood is not allowed for all women with a negative Rh factor. There are medical contraindications presented in the instructions with the following list:

  • hypersensitivity of the body to the active components of the injected drug;
  • prevention of Rh-conflict in newborns;
  • diabetes the expectant mother;
  • detected sensitization (Rh antibodies detected in the blood).

Special instructions for the use of anti-rhesus immunoglobulin

The serum cannot be used after the expiration date, non-observance of the rules and conditions of storage of the solution, as well as in case of violation of the integrity of the vial. Ideally, anti-rhesus immunoglobulin is a colorless liquid, therefore, if the solution changes its color and becomes cloudy, or a precipitate appears in the form of insoluble flakes, the bottle must be disposed of after opening. Vaccination is impossible, since it can significantly harm the patient's health. Other recommendations are presented below:

  1. Immediately after vaccination, the patient must remain under strict medical supervision. It is not excluded the appearance of side effects that specialists can productively stop with medication.
  2. Within 30 minutes after the injection, an allergic reaction may appear directly at the injection site of the serum. The task of the doctor is to stop anaphylactic shock if it occurs.
  3. Immunization with a "live" vaccine is carried out no earlier than 3 months after the administration of immunoglobulin.
  4. If there is a Rh-conflict between future parents, it is important to vaccinate even when planning a pregnancy. This increases the chances of having a healthy baby.
  5. In the presence of an infectious process, it is advisable to postpone the injection of immunoglobulin.
  6. Serum is not required for a Rh-positive parent or father with a negative Rh factor.

In the blood of Rh-positive people, there is a specific protein that is found on erythrocytes. 15% of the world's population are Rh negative, because they do not have this protein. The Rh factor is an individual inherited trait, but it does not affect human health in any way.

Usually, Rh affiliation should be determined together with the blood group in the laboratory.

What is Rh-conflict?

This phenomenon worries women with Rh-negative blood. During pregnancy, a conflict can arise between the mother and the fetus, provided that the child has inherited Rh-positive blood from the father.

Normally, maternal and fetal blood never mix, but placental abnormalities and trauma can cause fetal red blood cells to enter the woman's bloodstream. When a certain "concentration threshold" is reached, the mother's immune system begins to produce antibodies against a foreign protein (it is the Rh factor on the fetal erythrocytes) to destroy, ie, destroy the fetal blood. As a result, it occurs in the child. Sometimes the conflict can be so strong that malformations of the nervous system appear.

The likelihood of such a phenomenon is not so great, the first pregnancy (if there are no pathologies) most often ends well, but each subsequent pregnancy increases the risk of conflict by 10-15%.

Antibodies can also form in miscarriage, Caesarean section and placental abruption. The likelihood of sensitization depends on the number of fetal red blood cells that have entered the mother's body.

How to prevent Rh-conflict?

Although the Rh-conflict does not pose a danger to the mother's health, the consequences of hemolytic disease for the baby are very difficult, so it is worthwhile to prevent this phenomenon in all women who have blood negative for the Rh factor.

So, all pregnant women are assigned a blood test for early dates pregnancy to determine rhesus. The further algorithm of actions depends on the situation.

The first pregnancy is usually normal. Throughout the entire period, it is necessary to determine the level of anti-rhesus women. Up to 32 weeks, blood is checked once a month, up to 35 weeks - 2 times a month, and then every week. There should be no antibodies yet. If a Rh-positive baby is born, the mother must be sure to inject the drug "Anti-Rhesus Immunoglobulin" in the first 72 hours after delivery. Such a measure does not allow the appearance of antibodies to the Rh factor. This is necessary for the maintenance and normal course of subsequent pregnancy.

If there was an abortion, miscarriage, or this is also an indication for the introduction of "Anti-Rhesus Immunoglobulin".

A conflict over the Rh factor in the first pregnancy may be associated with a previously transfused positive blood to a woman who has a negative Rh factor.

How does Anti-Rhesus Immunoglobulin work?

The substance prevents the formation of antibodies to the Rh factor, which means the appearance of hemolysis of erythrocytes in the fetus.

Most often, the baby's blood enters the mother's bloodstream during childbirth, therefore, the introduction of the drug "Anti-Rhesus Immunoglobulin" is shown to a woman immediately after the baby is born. This measure is not being taken for this child, but allows you to prevent the development of hemolytic disease during the next pregnancy. At the discretion of the doctor, you can also administer the drug at 28 weeks of pregnancy, if there is a risk of mixing the two bloods before childbirth.

Anti-Rh immunoglobulin is contraindicated in case of detected sensitization (the presence of antibodies to the Rh factor in the blood of a pregnant woman), children, as well as women with Rh-positive blood. It cannot be administered intravenously. The dosage depends on the amount of blood (erythrocytes) that has entered the mother's body.

Anti-Rhesus Immunoglobulin allows a woman with Rh-negative blood to have as many children as she wants.

Human immunoglobulin anti-rhesus) Rho (D) is used for the prevention of Rh-conflict in Rh-negative women who are not sensitized to the Rho (D) antigen (i.e., have not developed Rh-antibodies) under the condition of pregnancy and the birth of a Rh-positive child, with artificial and spontaneous abortion, with interruption of an ectopic pregnancy, with the threat of termination of pregnancy at any time, after amniocentesis and other procedures associated with the risk of fetal blood entering the mother's bloodstream, as well as in the event of an abdominal trauma.

Contraindications Human immunoglobulin anti-rhesus RhO (D) solution for intramuscular injection 0.3 mg / dose 1 ml

The introduction of human immunoglobulin anti-rhesus Rho (D) is contraindicated in Rh-positive women in childbirth; Rh-negative puerperas sensitized to the Rho (D) antigen (whose serum contains Rh antibodies).

Method of application and dosage Human immunoglobulin anti-rhesus RhO (D) solution for intramuscular injection 0.3 mg / dose 1 ml

Human immunoglobulin anti-rhesus Rho (D) is used only intramuscularly. Before the start of the injection, the ampoules with the drug are kept for 2 hours at room temperature (20 ± 2) ° C. To avoid the formation of foam, the drug is drawn into a syringe with a needle with a wide lumen. The drug in the opened ampoule is not subject to storage. One dose (300 mcg) corresponds to 1 ml at an antibody titer of 1: 2000 or 2 ml at an antibody titer of 1: 1000. During pregnancy in Rh-negative women without sensitization phenomena, non-specific desensitizing therapy is performed at a period of 10-12, 24-25, 32 -33 weeks of pregnancy. Human immunoglobulin anti-rhesus Rho (D) is administered in a single dose (300 μg) intramuscularly. In case of RH (+) (positive Rh factor) of the husband's blood, the administration of immunoglobulin anti-rhesus Rho (D) 300 μg intramuscularly for a period of 28-30 weeks. Re-introduction of immunoglobulin no later than 48-72 hours after childbirth at the birth of a Rh-positive baby. At artificial interruption pregnancy at a gestational age of more than 13 weeks, the introduction of one dose of the drug (300 μg) is recommended. If the pregnancy is terminated at less than 13 weeks, it is recommended to administer 50 mcg of the drug. In case of trauma to the abdominal organs during the second or third trimester of pregnancy, it is recommended to administer one dose of the drug (300 mcg). If trauma to the abdominal organs requires administration of the drug at 13-18 weeks of gestation, another dose (300 mcg) should be administered at 26-28 weeks of gestation.

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The site provides background information for informational purposes only. Diagnosis and treatment of diseases must be carried out under the supervision of a specialist. All drugs have contraindications. A specialist consultation is required!

Immunoglobulins(antibodies, gamma globulins) are special compounds produced by cells of the immune system that protect a person from bacteria, viruses and other foreign substances (antigens).

Properties of immunoglobulins

Immunoglobulin not only performs a protective function in the body, but is also actively used in medicine. Qualitative and quantitative determination of antibodies of various classes is used to detect a variety of pathologies. Immunoglobulins are part of drugs for the prevention and treatment of infectious diseases, and a number of other conditions.

The human immune system and its functions

Normally, immunoglobulins are located on the surface of B-lymphocytes, are present in blood serum, in tissue fluid, as well as in secretions produced by the glands of the mucous membranes. Thus, different classes antibodies provide comprehensive protection of the body against diseases, representing the so-called humoral immunity.

Humoral immunity is the part of the immune system that performs its function in liquid media. human body... Those. antibodies do their job in blood, interstitial fluids, and on the surface of mucous membranes.

There is also cellular immunity exercised by a number of specialized cells (such as macrophages). However, it has nothing to do with immunoglobulins, and is a separate link of defense.

The immune response can be:
1. Specific.
2. Non-specific.

Immunoglobulin carries out a specific immune response, finding and neutralizing foreign microorganisms and substances. Against each bacterium, virus or other agent, its own, monoclonal antibodies are formed (i.e., capable of interacting with only one antigen). For example, antistaphylococcal immunoglobulin will not help with diseases caused by other microorganisms.

Acquired immunity can be:
1. Active:

  • formed by antibodies formed after a previous illness;
  • occurs after preventive vaccination (introduction of weakened or killed microorganisms, or their modified toxins, in order to form an immune response).
2. Passive:
  • immunity in the fetus and newborn child, to whom maternal antibodies have been transferred in utero, or during breastfeeding;
  • occurs after the vaccination of ready-made immunoglobulins against a specific disease has been made.
Immunity that forms after the introduction of ready-made immunoglobulin serum, or a prophylactic vaccination with a vaccine, is also called artificial. And antibodies transferred to the child from the mother, or acquired after the disease - by natural immunity.

Human immunoglobulin and its functions

Human immunoglobulin has the following functions:
  • "recognizes" a foreign substance (microorganism or its toxin);
  • binds to an antigen, forming an immune complex;
  • participates in the removal or destruction of the formed immune complexes;
  • immunoglobulin against the transferred diseases for a long time (sometimes - for life) remains in the body, which protects a person from re-infection.
Immunoglobulins also have many other functions. For example, there are antibodies that neutralize "extra", over-formed immunoglobulins. Thanks to antibodies, the transplanted organs are rejected. Therefore, patients with transplants need to take for life medications suppressing the immune response.

Antibodies are actively used in medicines. Currently, you can buy immunoglobulin at almost any pharmacy.

Immunity and immunoglobulins in children

Features of immunity in the fetus and infant:
  • in utero, the child does not encounter microorganisms, therefore, his own immune system is practically inactive;
  • during pregnancy, only class G immunoglobulins can pass from mother to child, which freely penetrate the placenta due to their small size;
  • detection of class M immunoglobulins in the blood serum of a fetus or newborn child indicates an intrauterine infection. Often it is caused by cytomegalovirus (symptoms of the disease: runny nose, fever, enlarged lymph nodes, damage to the liver and spleen, and others);
  • The immunoglobulins acquired from the mother in the blood of an infant remain for about 6 months, protecting it from various diseases, therefore, in the absence of pathology of the immune system, children practically do not get sick at this time.
During breastfeeding the child receives from the mother IgA immunoglobulins with breast milk, which provide additional protection for the child's body.

Finally, the formation of the child's immune system ends only by the age of 7 years. Distinctive features of the immunity of children are:
1. Insufficient ability to phagocytosis (absorption and destruction of cells of pathogens by human phagocytes).
2. Low production of interferons (proteins that provide nonspecific protection against viruses).
3. Decrease in the amount of immunoglobulins of all classes (for example, for immunoglobulin E, the norm in children is lower than in adults).

Therefore, it is natural that in the process of the formation of the body's immune system, the child is often sick. To help him form immunity correctly, his increase should be achieved by such means as hardening, swimming and other sports activities, being in the fresh air.

Immunoglobulins during pregnancy: Rh-conflict

A negative Rh in the mother during pregnancy, in combination with a positive Rh in the fetus, can lead to a condition such as Rh-conflict.

The mechanism of development of this pathology is associated with the fact that when a pregnant woman has a negative Rh - immunoglobulin can begin to be produced against fetal erythrocytes. This usually happens on later dates pregnancy. The threat of the occurrence of Rh-conflict increases with the pathology of pregnancy: inflammatory processes, the threat of interruption, increased tone of the uterus and others.

Rh-conflict can lead to severe hemolysis (destruction of red blood cells) in the fetus and newborn baby. The consequences of this condition can be:

  • severe hypoxia (oxygen starvation) of the fetus;
  • violation of metabolic processes, intrauterine growth retardation;
  • the appearance of edema, dropsy of the fetus;
  • miscarriages and premature birth, fetal death.
To prevent these complications, anti-Rh immunoglobulin may be prescribed by your doctor during pregnancy.

Anti-Rhesus Immunoglobulin During Pregnancy

Anti-Rhesus Immunoglobulin Rho (D) is used for the following purposes:
1. Prevention of the occurrence of Rh-conflict in a pregnant woman with a negative Rh factor.


2. Prevention of the formation of "harmful" immunoglobulins during abortions or other manipulations that can lead to the ingress of fetal serum into the mother's blood.

The price for anti-rhesus immunoglobulin is quite high, but when it comes to the health of a pregnant woman and her child, one should not save. Lower cost distinguishes domestic analogues of drugs. Therefore, you can buy a Russian-made anti-rhesus immunoglobulin, especially since there are no differences in the mechanism of action of the funds.

Self-medication with drugs containing antibodies is contraindicated. During pregnancy, other drugs, with the exception of anti-rhesus immunoglobulin, are not used.

Determination of the level of antibodies in the blood

Methods for the qualitative and quantitative determination of antibodies in blood serum have been developed for the diagnosis of various diseases.

Diseases of the blood and hypovitaminosis can also cause immunodeficiency. The most common of these is iron deficiency anemia, characterized by a low hemoglobin content in erythrocytes and a decrease in the amount of iron in the blood serum. This condition leads to oxygen starvation of tissues and, as a result, a decrease in immunity. Therefore, when hemoglobin is reduced, infectious diseases often occur. This is especially true for children, pregnant women or elderly patients.

Antibody affinity and avidity

Very often, not only total immunoglobulin and individual antibody fractions are determined in the blood. Usually, specialists are also interested in indicators such as avidity and affinity, determined for IgG and IgM.

The avidity of antibodies helps to identify the severity of the disease. For example, an acute or recently transferred (1-1.5 months ago) cytomegalovirus infection in children is confirmed by the detection of highly avid IgM antibodies, while their low concentrations can persist for up to two years.

Affinity indicates the strength of the interaction of antigens with antibodies. The higher the indicator, the better the antigens bind to antibodies. Consequently, a high affinity indicates a good immune response when this disease occurs.

When is an immunoglobulin test prescribed?

A blood test for immunoglobulin E is indicated for allergic diseases:
  • atopic dermatitis;
  • food, drug allergies;
  • some other conditions.
Normally, IgE is practically absent in the blood. If the total immunoglobulin E is elevated, this may indicate atopy - an innate tendency of the body to increased production of antibodies of this class, and indicates the possibility of allergic diseases. Increased immunoglobulin E in children or adults is an indication for consultation with an allergist-immunologist.

A blood test for immunoglobulin G is indicated in the following cases:

  • diagnostics of immunodeficiency states;
  • determining the presence of antibodies against a specific disease;
  • monitoring the effectiveness of therapy with drugs containing immunoglobulin.
Normally, the content of class G immunoglobulin is 70-57% of all antibody fractions.

Analysis of fractions for the determination of class M antibodies is used to detect acute infectious diseases. It is often prescribed to detect cytomegalovirus infection, Epstein-Barr virus, Helicobacter pylori bacteria, which causes gastritis and stomach ulcers, and other infections. Normally, the total amount of IgM is up to 10% of all immunoglobulins.

A blood test for immunoglobulin A is indicated for recurrent infectious diseases of the mucous membranes. The normal amount of IgA is 10-15% of the total amount of immunoglobulins.

Also, blood for immunoglobulin is donated for various autoimmune diseases. Specific antibodies and their complexes with antigens are determined in such pathologies as systemic lupus erythematosus, rheumatoid arthritis, autoimmune thyroiditis, myasthenia gravis and others.

Human Immunoglobulin: Uses

Human immunoglobulin is prescribed for the following diseases:
  • immunodeficiency states;
  • autoimmune diseases;
  • severe viral, bacterial, fungal infections;
  • prevention of diseases in people at risk (for example, in children born deeply premature).
There are also antibodies against certain conditions. For example, you should buy an anti-Rh immunoglobulin in case of Rh-conflict during pregnancy.

For severe allergic diseases, the doctor may recommend buying an anti-allergic immunoglobulin. This drug is effective remedy from atopic reactions. Indications for use will be:

  • allergic dermatitis, neurodermatitis, urticaria, Quincke's edema;
  • atopic bronchial asthma;
  • hay fever.
When the allergy in children is expressed, and its manifestations are constantly repeated, the use of antiallergic immunoglobulin can significantly improve the situation.

The importance of antibodies in vaccinations

Immunoglobulins are also used in the production of drugs for preventive vaccinations. They should not be confused with a vaccine, which is weakened or killed microorganisms, or their altered toxins. Immunoglobulins are administered in the form of sera and serve to create passive artificial immunity.

For the production of drugs for passive immunization, antibodies obtained from animals or human immunoglobulin can be used.
Immunoglobulin is part of preventive vaccinations against the following diseases:

  • mumps (mumps);
  • other.
Immunoglobulins are administered intramuscularly. They are also prescribed to patients who have had contact with a sick person and could become infected. In this way, you can reduce the severity of the disease, shorten its duration and prevent the occurrence of complications.

A separate variant of immunoglobulins is toxoid. It is an antibody, the action of which is not directed against the causative agent of the disease, but against the toxic substances produced by it. For example, toxoid is used against tetanus and diphtheria.

There are also emergency prophylactic agents containing human immunoglobulin. Their price will be an order of magnitude higher, but they are indispensable when it becomes necessary to travel to another country, which is an endemic zone of some dangerous infection (for example, yellow fever). Immunity after the introduction of these funds will be shorter (up to 1 month), but is formed already after a day.

However, it should be remembered that the introduction of immunoglobulin is not an alternative to a full-fledged preventive vaccination in accordance with the vaccination schedule, since the immunity that is being formed is shorter and not so strong.

Immunoglobulin preparations

Increasing immunity with folk remedies is possible. Fruits, vegetables and berries with a high concentration of vitamin C (a natural antioxidant) and other vitamins and microelements are especially helpful. But in some cases, it is necessary to administer an immunoglobulin to treat serious diseases and restoration of the body's defenses.

Normal human immunoglobulin is produced in vials containing a powder for preparation of a solution for injection or a ready-made solution (Immunoglobulin 25 ml). It contains IgG antibodies obtained from the plasma of healthy donors, as well as small amounts of IgM and IgA.

Normal human immunoglobulin is contained in the following drugs: Octagam, Pentaglobin, Anti-rotavirus immunoglobulin, Antistaphylococcal immunoglobulin, Normal human immunoglobulin, Complex immunoglobulin drug (CIP), Anti-Rhesus immunoglobulin, Anti-allergic and many others.

Immunoglobulin injections are given intramuscularly or intravenously only by a qualified physician. The dose of the drug and the duration of treatment are selected individually, taking into account the age and weight of the patient, as well as the severity of the disease.

Immunoglobulin treatment

Treatment with immunoglobulins is carried out only in a hospital, since these drugs can have a number of side effects, such as:
  • severe allergic reactions;
  • flu-like symptoms (chills

    Where can I buy?

    You can buy the drug at any major pharmacy, or on the Internet. Medicines containing immunoglobulin must be accompanied by instructions. However, it is strictly forbidden to use them without a doctor's prescription, since the drugs have a large number of contraindications. For example, during pregnancy and breastfeeding, immunoglobulin is prohibited.

    The price of immunoglobulin preparations can vary greatly, and depends on the specificity of antibodies, the manufacturer of the drug, the form of release, and other characteristics.

    Any medicinal products containing normal human immunoglobulin must be kept in the refrigerator (at a temperature of +2 - +8 o C).

    Before use, you must consult a specialist.