Jump to content

Anyone rhesus sensitized recently pregnant?


  • Please log in to reply
22 replies to this topic

#1 nonny1

Posted 14 January 2013 - 02:46 PM

Hi,


I unfortunately became rhesus D sensitized during my first pregnancy. In my next pregnancy the obstetrician was monitoring my titer levels but we lost the baby at 15 weeks due to chromosomal issues.

We are ttc again. The ob has said that next time around (if we are so lucky) the titer levels will not be an accurate way to see if problems are developing.

I'm interested to hear from anyone who is rhesus sensitized and has recently been pregnant. How did they monitor your pregnancy? If I fall pregnant again should I not be looking for a foetal-maternal specialist? Would my normal ob have to refer me? Did your baby need intra-uterine transfusions? Where were these done? Did your baby have any complications at birth or any complications later on?

Are there any support groups for ladies going through a rhesus sensitized pregnancy?

Any advice would be appreciated.

Thanks

#2 tibs

Posted 14 January 2013 - 02:51 PM

Sorry for your loss sad.gif   Didn't the anti-D work in your first pregnancy?

Not me personally but there was an EB'er called Karen who had was rhesus sensitised, she went on to have a baby that was affected and needed in utero transfusions but while born prematurely is otherwise healthy original.gif  I know she saw a special expert Obstetrican and was monitored very closely through her pregnancy.  Hopefully she is still around to share her story, she is a lovely lady who even makes little gowns for all the premmie babies original.gif



#3 Girlo

Posted 14 January 2013 - 02:55 PM

Is rhesus sensitise different to rhesus negative?? I am rhesus negative (but have only had one baby), is this something I need to think about?

Sorry, I can't offer any help OP, but I will be watching replies.

#4 Corella

Posted 14 January 2013 - 03:01 PM

Your antibodies to Rh+ should be checked if you are Rh- to make sure you're not sensitized.
I have a friend who was sensitized due to a mmc and needed close supervision in her pregnancy - her baby was at risk of becoming anemic and hydropic? I think was the term. He was in the end a Rh- baby too so it wasn't a problem.

#5 tibs

Posted 14 January 2013 - 03:15 PM

QUOTE (Girlo @ 14/01/2013, 03:55 PM) <{POST_SNAPBACK}>
Is rhesus sensitise different to rhesus negative?? I am rhesus negative (but have only had one baby), is this something I need to think about?

Sorry, I can't offer any help OP, but I will be watching replies.


If you are rhesus negative you can become rhesus sensitised if some of your baby's blood manages to mix with yours (if baby is rhesus positive).  This is why the 2 anti D injections during pregnancy and one after birth of a Rh+ baby are so important, as are Anti D injections after any bleed during pregnancy or after miscarriage or D&C.  I'm also Rh- and my DH has a ++ blood type so this is a big concern of mine.

#6 Natttmumm

Posted 14 January 2013 - 03:40 PM

I thought the anti D injections prevent that. I have had them for all my pregnancies.
I have negative blood and DH is positive. Both kids are positive.
Is this a different condition??

#7 Mousky

Posted 14 January 2013 - 03:55 PM

Anti D injections are routinely gives at 28 and 34 weeks gestation and after birth.  They need to be given within 72 hours of any bleed. Unfortunately, not all bleeds are obvious.

If you have a hidden bleed during your pregnancy, you will not know to have an anti D injection and then may become sensitised.

Also unfortunately, not all ob's will educate you on your need for anti D if you have a bleed. My first ob didn't offer it to me when I had my first missed miscarriage, even though I did start to bleed four days before the D&C (I had to wait 10 days), which was where I had the anti D. I was not sensitised thankfully, so s/he must have also been rh-.

So there unfortunatdly are reasons that some women wont get the anti D when needed and may go on to be sensitised.

#8 tibs

Posted 14 January 2013 - 05:30 PM

QUOTE (Mousky @ 14/01/2013, 04:55 PM) <{POST_SNAPBACK}>
Anti D injections are routinely gives at 28 and 34 weeks gestation and after birth.  They need to be given within 72 hours of any bleed. Unfortunately, not all bleeds are obvious.

If you have a hidden bleed during your pregnancy, you will not know to have an anti D injection and then may become sensitised.

Also unfortunately, not all ob's will educate you on your need for anti D if you have a bleed. My first ob didn't offer it to me when I had my first missed miscarriage, even though I did start to bleed four days before the D&C (I had to wait 10 days), which was where I had the anti D. I was not sensitised thankfully, so s/he must have also been rh-.

So there unfortunatdly are reasons that some women wont get the anti D when needed and may go on to be sensitised.


That is disgraceful that your Ob was so blase.  I've had a missed miscarriage and was booked the next week for a D&C but my Ob stressed that if I started to bleed I had to get the Anti D pronto.

#9 deejie

Posted 14 January 2013 - 08:07 PM

It is unusual in modern obstetrics for a women to be Rhesus isoimmunised. The introduction of preventative administration of Rh(D) immunoglobulin has done an amazing job of reducing the rate of Rhesus sensitisation.

Can a regular private OB handle an immunised pregnancy? Yes. But there are some who encounter it far more frequently. These OBs work within tertiary maternity hospitals and are more experienced in these matters than their private counterparts. Your GP can refer you directly.

Antibody titres are not the most reliable indicator of antibody "strength" anymore. Certainly a titre of 2048 for example is far more dire than a titre of 4, but there are many difficulties in standardising the reporting across different laboratories. Mostly the titres are still done for base reference, but certain antibodies including Anti-D can now be officially quantified.

The Rhesus type of your baby to determine their blood group used to be determined by extraction of material by amniocentesis. Of course this carried a small associated risk. These days, fetal DNA can be extracted from your blood sample from the mid second trimester onwards and typed for the Rhesus system.

If your titre/quant puts you in the "at risk" category, your baby used to be monitored by serial bilirubin levels in the amniotic fluid. This again required amniocentesis. These days, the vast majority of monitoring is done by MCA (middle cerebral artery) velocity which is measured by ultrasound. The premise is that as the antibody destroys baby's red blood cells, the baby becomes more anaemia. So the baby's heart beats faster to pump a smaller mass of red cells around the body quicker to provide oxygenation. Because the heart beats faster, the blood moves quicker. So an ultrasound of the MCA in an anaemic baby would show very fast flowing blood when compared with a non-anaemic baby (I hope this makes sense). The procedure is completely non-invasive.

If you do require intra-uterine transfusions, these are done in hospital using ultrasound to target the umbilical blood vessel. The procedure itself is very quick and you are usually kept for a short period of observation/fetal monitoring afterwards.

I'm not sure if there are any buddy groups on EB especially for immunised women. There used to be a High Risk Pregnancy buddy group a while ago, I'm not sure if it is still active.

I hope my post helps out. Feel free to PM me if you have any questions.

All the best original.gif



#10 nonny1

Posted 14 January 2013 - 10:00 PM

Thanks for all the replies especially deejie. I'd come across a lot of that info by googling but it was mostly in quite technical articles so it was great to have it explained so clearly.

For those who are wondering how I became rhesus sensitized - well it was partly my fault and I feel terrible about it. I had always been told (by my parents) that I was A+ and my first obstetrician never insisted on testing me. During my first pregnancy I did all the other tests and could kick myself (and him) now for skipping that one. It was only after the birth of DD (about a month after) when some of the paperwork had me down as O+ that I thought to have it checked. Turns out I'm A-. Then had hubby checked and he tested O+ (after always believing himself to be A+). You'll be pleased to know that this was not in Australia. When I next fell pregnant my titre levels were checked and I had become sensitized.

#11 weepingangel

Posted 14 January 2013 - 10:11 PM

Hi Nonny,

Deejie said it all really original.gif

I've had 5 pregnancies after I became iso immunised. I was always under MFM at the hospital. Regular bloods and scans, and based on those results determined the treatment during pregnancy, eg transfusions, early induction etc.

Remember that pregnancy is the first part, the jaundice after birth is the other issue.

My last DD was 10 days in special care with her niggly jaundice.
It was a nightmare to try and control!

FWIW my babies were never severely affected, all were induced early (35-36 weeks) so it really does depend on each woman as to how things go.

Good luck, it's certainly not doom and gloom, the MFM specialists really know their stuff original.gif

#12 tibs

Posted 14 January 2013 - 11:33 PM

QUOTE (nonny1 @ 14/01/2013, 11:00 PM) <{POST_SNAPBACK}>
Thanks for all the replies especially deejie. I'd come across a lot of that info by googling but it was mostly in quite technical articles so it was great to have it explained so clearly.

For those who are wondering how I became rhesus sensitized - well it was partly my fault and I feel terrible about it. I had always been told (by my parents) that I was A+ and my first obstetrician never insisted on testing me. During my first pregnancy I did all the other tests and could kick myself (and him) now for skipping that one. It was only after the birth of DD (about a month after) when some of the paperwork had me down as O+ that I thought to have it checked. Turns out I'm A-. Then had hubby checked and he tested O+ (after always believing himself to be A+). You'll be pleased to know that this was not in Australia. When I next fell pregnant my titre levels were checked and I had become sensitized.


Don't feel bad you weren't to know.  My parents are both A+ and had told me I was too - not that they had had me tested I guess they just figured since they were both A+ I would be too.  I only found out I was A- when I first became pregnant and had my bloods done - I think blood group is a standard preg bloods test here in Australia.  My parents still don't believe I am A-  blink.gif  Especially since all 3 of my kids are also A+ (my husband is O+).


#13 nonny1

Posted 15 January 2013 - 06:15 AM

QUOTE (pukeko~ponga~tree @ 14/01/2013, 11:11 PM) <{POST_SNAPBACK}>
I've had 5 pregnancies after I became iso immunised. I was always under MFM at the hospital. Regular bloods and scans, and based on those results determined the treatment during pregnancy, eg transfusions, early induction etc.


Good luck, it's certainly not doom and gloom, the MFM specialists really know their stuff original.gif



5!! Wow and congratulations biggrin.gif That makes me feel SO much better. We only want one more. Does every hospital have a MFM unit? At what stage in pregnancy do you go to them? I'm based in Sydney - I presume my gp or ob would know where the best hospital to refer me to would be once pregnant?

#14 nonny1

Posted 15 January 2013 - 06:30 AM

QUOTE (tibs @ 15/01/2013, 12:33 AM) <{POST_SNAPBACK}>
Don't feel bad you weren't to know.  My parents are both A+ and had told me I was too - not that they had had me tested I guess they just figured since they were both A+ I would be too.  I only found out I was A- when I first became pregnant and had my bloods done - I think blood group is a standard preg bloods test here in Australia.  My parents still don't believe I am A-  blink.gif  Especially since all 3 of my kids are also A+ (my husband is O+).


Thanks tibs - I'll try not to. Blood groups are weird. Its a good thing they're so pedantic here in Australia about testing because I think a lot of people make the same mistake (2 x + must equal +...but it doesn't always).

Its only since I've developed this problem that I've found out that we actually each have two signs after the letter:

For example if you're A- then you're actually A--. But if you're A+ then you could either be A++ or you could be A+-.

I'm not an expert but i reckon your husband is O++. The reason I think this is because my husband has been referred for his phenotype and apparently if he tests A++ then any baby of ours will be rhesus +. If he tests A+- then there is a 50/50 chance the baby will be rhesus -.

#15 CupcakeMumma

Posted 15 January 2013 - 07:43 AM

I'm  rh- AB and hubby is  a+ , so we have a B-, A+, B+ and a AB -, and yes I've had anti d a lot.  With monitoring and a good ob, things should be a okay for you original.gif.

#16 weepingangel

Posted 15 January 2013 - 09:15 AM

QUOTE
5!! Wow and congratulations  That makes me feel SO much better. We only want one more. Does every hospital have a MFM unit? At what stage in pregnancy do you go to them? I'm based in Sydney - I presume my gp or ob would know where the best hospital to refer me to would be once pregnant?


As soon as i went to my GP a referral was sent to the specialist. I'm positive Sydney will have a MFM unit. In NZ, i wasn't seen until 16-18 weeks by the Rhesus clinic ( As they were called!), in Brisbane i was 12 weeks when i saw MFM.

#17 deejie

Posted 15 January 2013 - 10:46 AM

QUOTE (nonny1 @ 15/01/2013, 07:15 AM) <{POST_SNAPBACK}>
5!! Wow and congratulations biggrin.gif That makes me feel SO much better. We only want one more. Does every hospital have a MFM unit? At what stage in pregnancy do you go to them? I'm based in Sydney - I presume my gp or ob would know where the best hospital to refer me to would be once pregnant?


See your GP when you are pregnant and they will be able to refer you to the nearest MFM unit.They are usually located in tertiary level hospitals and there are several in Sydney.

As P~P~t said, the MFM specialists really know their stuff, you will be in the very best of hands. They will typically see you after the first trimester, somewhere between 12-16 weeks depending on your initial titre/quant level. It's certainly not doom and gloom as the internet might have you believe. I have worked with them in two hospitals and although sometimes it can be a long and stressful haul with premature babies, transfusions and long stays in special care, I can't remember anyone who didn't bring home their little baby at the end.

All the best.

#18 nonny1

Posted 15 February 2013 - 05:58 PM

Hi ladies,

It's me again. Well I'm 4 1/2 weeks pregnant (I think). I did the usual pregnancy blood tests yesterday plus the rhesus titer. My GP just called to say it's in the 1000's!!! She wants to see me on Monday to refer me to an ob but said this could indicate this baby has rhesus disease and if I have any bleeding or feel ill over the weekend I must go to the hospital. I'm seriously freaking out now...this is not the call I wanted to get at 6pm on a Friday evening...


Is this as bad as she's making it sound? Could the levels not be off because of my tfmr last year? I thought the titers weren't reliable for 2nd or later sensitized pregnancies? Please tell me there is some hope....

#19 my4beautifulboys

Posted 15 February 2013 - 06:44 PM

I was just reading as i'm rhesus negative also, with my three children ive had all the Anti -D injections, ive also had 3 m/c since, and after the two, which ended in a D&c i think i had the Anti -D. But i did have a Mmc in November last year, and that was a natural m/c, so i didnt have the Anti-D then.

Now i'm pregnant again and i'm 5 weeks now. Is it ok that i didnt have the Anti-D after my last m/c or not. I will be seeing my Gp next week, should i suggest to him that i have a blood test to check?

Thankyou and best wishes to you all.

#20 nonny1

Posted 16 February 2013 - 04:37 AM

Hi my3beautiful boys,

I think I read somewhere that the chances of becoming sensitised during the 1st trimester are quite low. Also the rhogam lasts for a while so you might have still been covered from a previous shot.

I would mention it though to your GP next week. They can add the test to all the other normal pregnancy ones. I think it would be good to check - I'm all for checking and double checking after the mistake that got me to this place.

#21 my4beautifulboys

Posted 17 February 2013 - 03:03 PM

hi  nonny1, thanks for youre reply. Im going to be seeing my Gp this week so i ll definately mention that to him, perhaps he could include a blood test in with the other routine ones to check for sensitisation.

I think its easy to be overlooked for that particular blood group that we are Rh-, and its quite rare. I think that sometimes they need reminding! Which doesnt seem right.

My 3 children are all + type blood groups, so they get that from Dh, and not me. So Its very important.

All the best.

#22 deejie

Posted 17 February 2013 - 07:09 PM

QUOTE (nonny1 @ 15/02/2013, 06:58 PM) <{POST_SNAPBACK}>
Hi ladies,

It's me again. Well I'm 4 1/2 weeks pregnant (I think). I did the usual pregnancy blood tests yesterday plus the rhesus titer. My GP just called to say it's in the 1000's!!! She wants to see me on Monday to refer me to an ob but said this could indicate this baby has rhesus disease and if I have any bleeding or feel ill over the weekend I must go to the hospital. I'm seriously freaking out now...this is not the call I wanted to get at 6pm on a Friday evening...

Is this as bad as she's making it sound? Could the levels not be off because of my tfmr last year? I thought the titers weren't reliable for 2nd or later sensitized pregnancies? Please tell me there is some hope....


Hi Nonny,

Sorry to hear of the news of your high titre. There is some variation in titres from lab to lab, but these variations are minimal and if a lab has measured your titre in the thousands then it certainly is very high. Titres are one of many clinical tools used in the assessment of risk of haemolytic disease in the fetus. A high titre does indicate an increased risk, but other diagnostic tests are used to more accurately assess this later in your pregnancy.

When you are referred to the OB at the Maternal Fetal Medicine unit, they will most likely test your blood for a quantitative Anti-D. They will most likely see you after your first trimester, usually somewhere between 12-16 weeks.

I have seen a woman with an Anti-D titre of 64,000. She bought home a beautiful baby girl after a long and difficult road. The MFM specialists really know their stuff and you will be in the very best of hands. You can PM me if you ever want to chat.

QUOTE
Now i'm pregnant again and i'm 5 weeks now. Is it ok that i didnt have the Anti-D after my last m/c or not. I will be seeing my Gp next week, should i suggest to him that i have a blood test to check?


3beautifulboys-- it is within standard practice not to give Anti-D for a naturally occuring miscarriage in the first trimester. Your GP should perform a group and antibody screen as part of the standard first trimester blood tests.

#23 RealityBites

Posted 17 February 2013 - 07:59 PM

Not sure whether this is helpful but my friend was not given anti-d after her second birth and went on to have an early miscarriage with # 3. When they became pregnant again, her husband's blood was tested to see whether he could have a + or - child. They also had an amnio to make sure baby was ok. She was, thankfully.




0 user(s) are reading this topic

0 members, 0 guests, 0 anonymous users

 

Exclusive Black Friday Sale!

Get over 40% off selected products, including prams, baby carriers, cloth nappies, sleeping bags and much more! 24 hours only, on May 6 - register now for your special code.

Kelly Clarkson shares first photos of son

Kelly Clarkson has shown off the first photos of her son, Remington Alexander Blackstock.

5 childbirth myths that need to be busted

Birth is an unpredictable, mysterious process that intrigues us all, and there is a lot of misinformation out there.

Mum of three fatally shot by toddler while driving

A US mother has been shot by her toddler while driving on a highway in Wisconsin.

All you need is one minute to work out

The seven-minute-work out is old news. Research shows the effectiveness of going hell-for-leather for just one minute.

Pregnant women needed to join diabetes study

Pregnant woman in country Australia will help Adelaide researchers figure out why cases of type 1 diabetes have doubled over the past two decades.

Just announced: the Mountain Buggy Unirider

It's the perfect solution to combat those toddler meltdowns when they no longer want to be in a pram but can't walk long distances.

Authorities euthanise dog that fatally bit a newborn baby

A pit bull mix that fatally bit a 3-day-old infant last week has been euthanised, authorities said.

The push for Medicare to fund lactation consultants

While meeting with a lactation consultant can make an enormous difference to a new mother, it's not a service that is available through the public health system.

Why it's perfectly natural to dislike other people's children

Members of a popular forum are fiercely debating whether it is acceptable to dislike a friend's child.

Woman gives birth on plane, names baby after airline

A pregnant woman who unexpectedly gave birth on a flight has named her new baby after the airline, Jetstar.

Heartwarming photos show the joy of adoption after foster care

Children living in foster care can feel like their future is less than clear. But that uncertainty disappears the day they are adopted by their "forever family" 

'Oh my god, it's a baby!' Mum shocked to give birth

When the cramps started to kick in, Klara Dollan just assumed a painful period was starting.

Mum's Facebook plea: 'Help me find my daughter's father'

Kerryn has a unusual present planned for daughter Imi's 13th birthday celebrations - she hopes to be able to be able to give the soon-to-be the teenager her first ever photo of her dad.

Is it possible for your house to be too clean?

Our houses are cleaner than ever before. But how clean is too clean? Could a sterile home be putting your family's health at risk?

Millions of Monkeys: puzzles that grow with your toddler

Here's a puzzle that grows with them; the Puzzle Grow Pack by Millions of Monkeys.

Baby names from Britpop

If you grew up in the 90s you might want to look to the genre of Britpop music for baby name inspiration.

What to eat and drink when you have gastro

When you catch a bug that causes acute infectious gastroenteritis (gastro), your stomach and intestinal tract become inflamed, causing diarrhoea, nausea, vomiting, abdominal cramping and pain. The last thing you probably feel like doing is eating.

'To this day, I owe her my life'

Would I have survived if I hadn't crossed that street?

Why baby Sonny needs you to vaccinate your children

Caitlin is a firm believer in the importance of immunisation to protect children from harmful and deadly diseases.

Five-year-old's photo captures beauty of motherhood

There is no make-up or special outfits and hairdos, but the five-year-old boy who took this picture captured the essence of motherhood as well as any professional photographer.

Babies know whether you are naughty or nice

Studies have shown that infants in the first months of life try to avoid dealing with social wrongdoers - for example, sharing less with them and helping them less - and they expect others to, too.

 
Advertisement
 

Top 5 Articles

Advertisement
 
 
 

What's hot on EB

The babies who are one in 70 million

Bethani Webb was excited to find out she was pregnant, but the first time mum did not realise she was carrying four babies not one.

Exclusive Black Friday Sale!

Get over 40% off selected products, including prams, baby carriers, cloth nappies, sleeping bags and much more! 24 hours only, on May 6 - register now for your special code.

Cafe offers breastfeeding mums a free cup of tea

A Sydney cafe is offering breastfeeding mums free cups of tea in a bid to show support for the right of women to nurse their babies wherever they choose.

To snip or not to snip? When the decision is not clear cut

Jamie Oliver, who considered a vasectomy, is to be a father again. A fellow dad reflects on his own decision 11 years ago

Doctors stunned by rare twins born almost six weeks apart

To everyone's surprise, Kristen Miller "kept doing better each day", keeping her second baby safe.

Baby book ideas for modern parents

Before my son was born I was given a lovely baby book full of blank pages waiting to be filled with weights and heights and first words.

The adorable smile of a baby seeing his mum clearly for the first time

There is no doubt seeing their child smile for the first time is an unforgettable moment for parents everywhere.

Mum tells how toddler 'nearly hung himself' in cot mishap

When Alison Johnson put her 18-month-old Caleb down for a nap, she had no reason to believe her son was in any danger.

Babies are still switched at birth? Yes, it can happen

All my panic and tears aside, my biggest question looking back is about the kind of security measures used in the maternity ward.

Doctors slammed for taking selfie with newborn

Everyone who visits a mum in hospital in the days following childbirth wants to get a photo with the new baby.

ergoPouch Twosie Sleepsuit for winter breastfeeding

Finally, there's a way to keep warm while breastfeeding through winter.

Health check: How long does sex 'normally' last?

What to do with this information? My advice would be to try not to think about it during the throes of passion.

When breastfeeding sucks: fixing common problems

From niplash to tight boobs, biting to milk supply issues, Pinky McKay looks at common breastfeeding issues and how to solve them.

10 things I've learnt in my first six months with twins

Six months on we're all still alive, and the more we get to know each other the easier the days become.

Mum's loving kiss leaves baby fighting for life

Kirsty Carrington thought nothing of giving her newborn son a kiss, little did she know it would leave the baby fighting for life.

When doing chores is your new 'me time'

After children, 'me time' looks a little different.

Get going: 14 travel strollers for families on the move

A stroller can make or break travelling with a baby or toddler. Here are 15 great single travel stroller options.

10 ways toddlers are terrific

It always pays to remind yourself of how terrific toddlers can be - they're little like this for such a short time

 

ENTER NOW

Do your kids love bananas?

This is the comp for you! We have $800 worth of Myer gift cards and boxes of Australian Bananas to be won. Entry is simple: just post a pic of your little one enjoying a banana in the comments of the FB post to enter.

 
Advertisement
 
 
Essential Baby and Essential Kids is the place to find parenting information and parenting support relating to conception, pregnancy, birth, babies, toddlers, kids, maternity, family budgeting, family travel, nutrition and wellbeing, family entertainment, kids entertainment, tips for the family home, child-friendly recipes and parenting. Try our pregnancy due date calculator to determine your due date, or our ovulation calculator to predict ovulation and your fertile period. Our pregnancy week by week guide shows your baby's stages of development. Access our very active mum's discussion groups in the Essential Baby forums or the Essential Kids forums to talk to mums about conception, pregnancy, birth, babies, toddlers, kids and parenting lifestyle. Essential Baby also offers a baby names database of more than 22,000 baby names, popular baby names, boys' names, girls' names and baby names advice in our baby names forum. Essential Kids features a range of free printable worksheets for kids from preschool years through to primary school years. For the latest baby clothes, maternity clothes, maternity accessories, toddler products, kids toys and kids clothing, breastfeeding and other parenting resources, check out Essential Baby and Essential Kids.