Antibody titer during pregnancy: concept, indications for blood donation and interpretation of the results

2024 Author: Priscilla Miln | [email protected]. Last modified: 2023-12-16 00:21

Proteins-antibodies - produced by the lymphatic system of the body, play a leading role in the functioning of the immune system. Their main task is to join red blood cells, to resist antigens that are unnatural for humans.

Antibody titer during pregnancy is a quantitative indicator of the concentration of synthesized antibodies of the expectant mother. Pregnant women do not have a stable psycho-emotional state, therefore, they must understand the essence of the study and be able to donate blood correctly, not be nervous, unreasonably trying to decipher the meanings.

What is the essence of laboratory analysis

During the period of gestation, a woman's body undergoes changes, becomes more vulnerable, and the pathologies that previously occurred in a chronic form become aggravated. In pregnant women, the barrier functions of the body are weakened, which is often the cause of the introduction of infections, and, therefore, carries the risk of abnormalbaby development.

Testing for antibodies to infections is mandatory. Thus, resistance to TORCH is determined: rubella, toxoplasmosis, herpes, etc. For a baby developing in the womb, they are detrimental. The infection can adversely affect the nervous system, change the course of pregnancy, provoke fetal fading, premature birth, or the appearance of a child with obvious signs of pathologies.

Women are anxiously waiting for the results of the analysis, because if antibodies to infections are found, then there is no need to worry - nothing threatens the fetus.

Rh antibodies during gestation

In the middle of the first trimester, antibodies are intensively synthesized, which is the cause of the Rh conflict. The concentration of protein in people with a positive Rh factor is 85%. When the indicator does not match, and there are no such proteins, we are talking about a negative Rh.

The danger is that a pregnant woman with a negative Rh can carry a baby who has inherited the father's Rh factor - positive. In the second trimester, the mother's antibodies are introduced into the placenta and aggressively act on red blood cells, which subsequently has a detrimental effect on the development of the baby. As a result, liver dysfunction occurs, disruption of the heart muscle, and the brain suffers. The outcome of such a development is sad, as the fetus freezes.

Negative factors for bearing a baby in conflict:

• ectopic pregnancy;
• blood transfusion (hemotransfusion);
• abortion of pregnancy for various reasons;
• placental abruption;
• cesareansection;
• manual separation of the placenta;
• puncture of the amniotic membrane (amniocentesis);
• lack of prevention.

For women, Rh negative usually sounds like a sentence, and they deny themselves the happiness of being a mother. It must be understood that the antibody titer during the period of gestation increases if the erythrocytes of the fetus are introduced into the mother's bloodstream.

By donating blood for antibody titers during pregnancy, their function is determined in a particular case. If they are fighting TORCH infections, there is no reason to be concerned. Also, antibodies can identify the fetus as a foreign agent and concentrate aggressive activity against it, which is fraught with a threat to the baby. The antibody titer during pregnancy with a negative Rh factor increases. This contributes to the development of Rh conflict.

Laboratory tests for antibody titer during pregnancy

The task of the leading specialist is to timely identify threats to the mother and fetus, eliminate them or stop them. It is important to prevent abnormal development of the baby.

Analysis for antibody titers during pregnancy to:

• TORCH;
• Rhesus conflict;
• blood type incompatibility.

In order not to panic for no reason, it is worth delving into the topic and analyzing each case separately.

TORCH

TORCH - a group of different infections united in 1971 with a common property - to bring danger to the developing fetus and newborn. The decoding of the abbreviation includes the initial letters of the maininfections:

• T - toxoplasmosis;
• O - chlamydia, hepatitis A and B, gonorrhea, listeriosis, gonococci;
• R - rubella;
• H - herpes.

If you approach the issue of pregnancy consciously, it is worth passing tests for TORCH during the planning period for conception. The presence of antibodies guarantees a calm period of gestation for a woman. The absence of antibodies is a reason for a second blood donation or a search for a solution to the problem.

The main danger of TORCH infections is significant during the primary infection. If we are talking about an exacerbation of an existing disease, dangerous manifestations are less common.

The consequences of the absence of antibodies can be unpredictable. First of all, the nervous system suffers. A failure in the full development of the fetus is also possible, which can provoke a spontaneous abortion.

To determine the degree of danger, the doctor pays attention to the titers and the type of immunoglobulin (IgG, IgM). The detection of IgG antibodies indicates the presence of immunity in the mother and baby. A "positive" result is not always a cause for panic.

It is worth noting that only rubella makes itself felt with vivid symptoms. In other cases, the infection may be asymptomatic. Most cat owners have antibodies to toxoplasmosis. Women who do not have antibodies to this type of infection will be forced to take the test more than once. TORCH infections are relatively safe for adults, babies and expectant mothers, but they carry a deadly threat to the fetus.

Immunoglobulins of classes M and G are considered important indicators in the diagnosis.the absence suggests that the woman is absolutely he althy and has not encountered rubella, herpes. It is worth noting that this is not a reason for the joy of a pregnant woman. Throughout the entire gestation period, you will have to undergo monthly repeated examinations, avoid crowded places, public catering. The lack of protective mechanisms has been a concern for all 9 months.

Rh-conflict

With different Rh factors in parents, if the fetus inherits Rh that does not match the mother's, isoimmunization develops. Predominantly, the danger is more likely with repeated pregnancies if the woman has not taken preventive measures aimed at combating the development of immune conflict.

Rhesus conflict is dangerous for the development of hemolytic disease in an infant. The destruction of erythrocytes entails severe forms of disease with unfavorable prognosis for recovery. If antibody titers are elevated, a Rh conflict during pregnancy is more than likely, and all necessary measures should be taken to stop the development of pathologies.

ABO conflict

With different blood types in mother and baby, there is a possibility of the formation of an ABO antibody titer during pregnancy. Usually this phenomenon is characteristic of women with group O, carrying a fetus with blood type A or B.

Worth paying attention to the following combinations of blood types:

1. Mom A - Father B.
2. Mom B - father A.
3. Mother A or B - father AB.

To avoid unnecessary worries,it is worth noting that the conflict in blood types is less dangerous than allogeneic. It is recommended to donate blood for antibody titers during pregnancy, since signs of hemolytic disease are possible, although it is mild and does not require therapeutic action.

When tests are ordered to detect antibodies

In the first pregnancy, provided there is no history of miscarriages, abortions, the study is carried out once in the period from 18 to 30 weeks. Twice between weeks 30 and 36.

When an antibody titer of 1:4 is detected during a pregnancy that is not the first time - the analysis is done once a month, with a risk of titer - the doctor may consider it appropriate to prescribe it up to 2-3 times. The examination takes place at the end of the first trimester (weeks 7-8) and then is performed according to the instructions of the gynecologist.

How to pass an analysis for credits

An analysis of antibody titers during pregnancy is important to pass correctly, since the results are very important, and the further development of pregnancy and the fetus may depend on them. To get objective indicators, you should adhere to the following rules:

• a he althy diet should be followed a few days before donating blood;
• necessary to exclude drinks that include caffeine and soda;
• physiotherapy procedures are not performed before tests;
• taking medications is agreed with the doctor, if possible excluded;
• donate blood on an empty stomach - breakfast will have torefrain.

Timely delivery of tests, the implementation of the recommendations of the leading specialist increases the likelihood of a successful pregnancy outcome.

Normal performance

The norm of antibody titer during pregnancy varies within (g/l):

• lgA - 0, 35-3, 55;
• lgG - 7, 8-18, 5;
• lgM - 0, 8-2, 9.

The absence of lgM and lgG antibodies indicates that the woman has not experienced infection before. The situation is dangerous because there is a high probability of infection during the period of gestation. In such a situation, monthly control is indicated.

A positive result confirms the presence of antibodies, but additional testing is advisable to rule out possible risks to fetal development.

You should also know:

• lgG - positive, lgM - negative - no effect on the fetus, since the infection was transferred earlier;
• lgG - negative, lgM - positive - indicates that the infection has joined during pregnancy;
• when examining antibodies to TORCH infections in normal lgM values should not be;
• lgG class antibodies are considered normal variant.

If lgG to rubella is not detected or an insufficient amount is detected, that is, the level is negative, they are vaccinated. It should be noted that the method is suitable as a preventive measure and is allowed when planning a pregnancy. Conception is possible after 2-3 months at a rate of antibodies to phospholipids of 10 U/ml.

To exclude possible risks of pathological developmentfetal antibody titer during pregnancy with a negative Rhesus is monitored throughout the term. The concentration is clearly defined in 1 ml of solution.

When determining the presence of antibodies in a woman during the period of gestation, it is important to know that a ratio of 1:4 is considered a normal value. A sharp excess of the norm is a reason to monitor the condition of the baby through ultrasound. The growth of antibodies is monitored by constant testing. With stable values, there is a high probability of a successful development of events for the pregnant woman and the fetus. With growing titers, it is advisable to administer immunoglobulins.

What is the danger to the fetus

Antibodies should be determined in the blood of a pregnant woman, since the analysis is of relative importance in diagnosis. An accurate result can be obtained in combination with other tests. Particular attention is paid to the value of the titer and its change during pregnancy, the deviation in performance.

Antibody titer is calculated in relation to the highest amount of serum dilution at which it can agglutinate Rh-positive erythrocytes. Ratio: 1:2; 1:4; 1:8; 1:16, etc. - is an indicator. Accordingly, the higher the titer, the greater the concentration of antibodies and the less favorable prognosis for the course of pregnancy. A high antibody titer during pregnancy is a dangerous indicator.

Impact on fetal development:

1. With an antibody titer of 1:4, the course of pregnancy is Rh-conflict. At higher rates (1:16), amniocentesis is prescribed. It should be noted that high titers often lead to abortion. Puncture of the amniotic membrane allows laboratory control or administration of drugs. Manipulation is carried out after 26 weeks.
2. Elevated antibody titer during pregnancy (1:61) indicates that early delivery by caesarean section is indispensable.
3. Identified in the blood antibodies to toxoplasmosis in the first trimester may indicate infection in the fetus. Subsequently, this may affect the state of the nervous system, liver, spleen. With the addition of toxoplasmosis at a later date, the course is less dangerous, practically does not cause complications. With an accurate diagnosis of the problem in the early stages, the doctor may recommend termination of the pregnancy.
4. Revealed antibodies to rubella in a pregnant woman is a dangerous indicator. The organs of vision of the fetus, the myocardium and the nervous system are affected. When infected in the first trimester, termination of pregnancy is indicated. Subsequently, the likelihood of a dangerous development is significantly reduced. As a result of the disease, there is a lag in growth and development, dysfunction of vital organs.
5. If the test detected antibodies to cytomegalovirus infection, this can cause the fetus to freeze. A newborn who survives has a congenital pathology - dropsy of the brain, liver hypertrophy, heart disease.
6. Signs of immune aggression appear with the growth of antiphospholipid antibodies. Immune cells lead to the destruction of phospholipids, due to which the antiphospholipid syndrome develops. This condition is fraught with miscarriage, asphyxia, placental abruption,intrauterine disorders. All abnormal deviations are associated with a change in blood circulation in the placenta.

Knowing the dangers of antibody titers during pregnancy, women are more responsible in planning pregnancy.

How to eliminate negative effects on the fetus

Rhesus conflict between the fetus and the pregnant woman leads to dangerous consequences. To avoid difficult moments, you should listen to the doctor's recommendations on how to reduce antibody titers during pregnancy. First you need to go through the program "Anti-Dgamma-globulin". The same actions are appropriate after the birth of the baby and with a negative Rh factor in the results of the child's blood.

It is worth paying the doctor's attention to the situation when a woman, under various circumstances, gets hit in the stomach. The opening of bleeding or leakage of the placenta is the reason for the introduction of gamma globulin. In this case, anti-Rhesus immunoglobulin is administered at the 7th month and after the resolution of pregnancy on the third day.

Don't doubt the doctor's appointment for testing. Thus, many problems associated with the course of pregnancy and the development of the fetus can be excluded.

Changes in the body of a pregnant woman are monitored for 9 months. The absence of antibodies in the blood before 28 weeks, or when the rate does not exceed 1: 4, leaves cause for concern. Accordingly, it is likely that antibodies are able to respond later and more strongly. An antibody titer of 1:2 during pregnancy is already an indicator thatthat specialist supervision is required throughout the entire period.

The risk of manifestation of the Rhesus conflict makes the leading specialist play it safe and, to prevent deviations, introduce immunoglobulin D (anti-Rhesus). It is worth noting that the vaccine does not pose a threat to the woman and the fetus. Also, the injection should be repeated after childbirth. Thus, complications in the future are excluded.

If the blood circulation exceeds the limits of 100, an emergency caesarean section is indicated. The well-being of the baby depends on the speed of decision-making and the professionalism of doctors.

When diagnosing a hemolytic disease, an increase in the number of antibodies, therapeutic actions are carried out in utero. If a blood transfusion is not possible, the baby's lungs are formed - they stimulate early labor.

Modern technologies allow for plasmapheresis or a decrease in the concentration of antibodies in maternal blood. The method is effective and is used in the second half of pregnancy.

You can also purify the blood of toxic compounds by passing the mother's blood through a filter. Hemosorption allows you to return already purified blood to the circulatory system.

If the situation so requires, the doctor may prescribe injections to accelerate the development of the respiratory system of the fetus after 24 weeks. In this way, an emergency premature birth is carried out and the baby is saved.

After the birth of a baby, specialists examine the newborn, prescribe manipulations appropriate to his condition:

• phototherapy;
• plasmapheresis;
• transfusionblood.

Not all hospitals can provide a specialist who can competently perform intrauterine blood transfusion. The procedure is complicated, because during the ultrasound examination, blood is injected into the fetal abdomen or the umbilical vein is pierced with a long needle.

What women at risk should know

Antibody titer during pregnancy is an important indicator, since no one is safe from infections, Rhesus conflict. Expectant mothers should remember:

• blood transfusion must be strictly from a donor with identical Rh;
• any abortion - the risk of increasing antibodies in the blood with the desired conception;
• Rh-negative women should be especially careful about contraception;
• after giving birth, the Rh of the newborn should immediately be determined;
• doctors have 72 hours after delivery to administer immunoglobulin.

Women with a negative Rh should know all the nuances, if necessary, point them out to the doctor.

Conclusion

The protective functions of the body are not stable, the immune system can fail for various reasons. According to statistics, most of the world's population has a positive Rh factor, only 15% - negative. The problem arises when the baby has inherited the Rh provocateur from the father, causing a conflict when in contact with the mother's blood.

To exclude the immune response of the body and the risks of abortion, the development of a fetus with pathological abnormalities is seriouslyapproach the issue of conception. Timely examination, taking measures to prevent unexpected deviations from the norm, will allow the expectant mother to calmly endure 9 months and guarantee the birth of a he althy baby.