Jump to content

Anyone know much about anti e antibodies and amniotic fluid embolisms?


  • Please log in to reply
3 replies to this topic

#1 *~~Jess~~*

Posted 25 January 2013 - 06:49 PM

After the birth of DD2 I developed an amniotic fluid embolism and also diagnosed with anti e antibodies.

It was discovered that I still have the antibodies when I had bloods done for this pregnancy. I have spoken to my OB and the chance of another embolism occurring is low but I will need to see the high risk clinic because of the antibodies and the risk to my baby because of them.

Has anyone else had an amiotic fluid and not had another one in your next pregnancy?

Also has anyone had anti e antibodies, did your baby have any side effects at birth because of it?

#2 kwiggle

Posted 25 January 2013 - 07:07 PM

Congrats on your pregnancy Jess - I reckon you'll be pretty bored of hospitals and doctors by the end of this one! biggrin.gif
The most likely thing is that your pregnancy will be boring, but they will take lots of blood tests to make sure your antibody levels remain stable, and if they go up will do lots of ultrasounds to check whether your baby is becoming anaemic.  Worst case scenario (and pretty rare) is that your baby would need blood transfusions in utero.  
In terms of the amniotic fluid embolism.... noone will be able to tell you what the risk of recurrence is reliably because it's so rare.  My best guess is that it's unlikely to happen again.  
You're a brave lady - are you coping with the idea of being pregnant again?  I hope you don't have too many scary thoughts.... I don't have any personal experience with those issues, but wanted to reply because I can imagine it's going to be a stressful time for you.  Good luck!

#3 katpaws

Posted 06 March 2013 - 10:31 AM

Hi Jess

I had an AFE 10 years ago but have been diagnosed with secondary infertility so no second baby.  I had decided to go for a CS (elective) if i got pregnant again  - the AFE occured during an attempted vaginal birth.

I understand that the chance of another AFE occuring in subsequent pregnancies is very very low. However, my OB did advise having an CS and avoiding labour with another baby, however my AFE was pretty bad so this may affect medical advice given.

I would recommend that for your next pregnancy you have an OB you have a high level of trust in and in the health professionals supporting you. If you suffer from PTSD you need to advice your medical team, also be aware that flashbacks to the AFE could occur so have a management plan for that. I would advise having someone with you during your labour or CS (whichever way you go) and not being left alone, even for a few minutes, so someone is always monitoring you.

When you book your hospital ask them about their AFE management plan ie do they gave the cogulation products needed on hand? Do they have an intensive care ward in case things go wrong?

AFE is on the suckiest worst things that can happen to you. The fact that it is not predictable and can't be tested for just makes it such a horrible thing.

Best of luck with everything




#4 deejie

Posted 06 March 2013 - 09:01 PM

QUOTE (*~~Jess~~* @ 25/01/2013, 07:49 PM) <{POST_SNAPBACK}>
Also has anyone had anti e antibodies, did your baby have any side effects at birth because of it?


Anti-e (lower case) is a different antibody to Anti-E (uppercase). I'm not sure if you meant the lower case "e" or not, so will cover both.

Anti-E can sometimes be naturally occuring. The naturally occuring Anti-E antibodies are usually low titre and of little clinical concern. Immune Anti-E which were stimulated by previous pregnancy/transfusion are usually associated with mild -> moderate effects in the developing fetus. Severe fetal anaemia from Anti-E antibodies is uncommon.

Anti-e antibodies are very rarely naturally occuring and are usually the result of previous pregnancy/transfusion. They are typically associated with mild -> moderate effects in the developing fetus and like Anti-E, severe fetal anaemia is uncommon.

Your partner will be tested for the E/e antigen. If he is heterozygous (one copy of the gene), your baby will have a 50/50 inheriting it and being at risk. If he is homozygous (two copies of the gene), your baby will definitely carry the E/e antigen and will be at risk.

I'm sure you will be sick of ultrasounds and tests by the time your pregnancy is done!
Most antibodies are still quantitated in the laboratory by a test called the  antibody titre which is performed on a sample of your blood. This gives a rough estimate of the "level" (for lack of a better word) of antibody in your blood. The higher the titre, the higher the level of antibody and (generally speaking) the higher risk involved for your baby. In some pregnancies, the titre remains stable throughout. In other pregnancies, it can go up a little or a lot.

There are ways of typing the baby for the E/e antigen before it is born. It can be done via amniocentesis and extracting fetal DNA from a sample of amniotic fluid. Amnio obviously carries risks. Fetal e/E antigen typing can also be done on a sample of maternal blood from the second trimester. Fetal DNA can be extracted and typed. These tests are usually done when the maternal antibody is one of the "nasty" ones (D, K, c), the titre is very high the baby is considered at high risk. It is rarely done in the case of Anti-E/e. Otherwise, monitoring tests will show whether the baby is affected.

If your titre is high, your OB team will monitor the health and wellbeing of your baby by MCA (middle cerebral artery) ultrasound. They measure the velocity (speed) of the blood in the middle cerebral artery in your baby's brain. If you have lots of antibody crossing the placenta and destroying your babies red blood cells, your baby will be anaemic. Its heart will beat faster to pump a smaller volume of red blood cells around its body and therefore the velocity of the blood increases. The velocity of the blood is a good indicator of how anaemic your baby is and the treatment it needs (further monitoring, early delivery, transfusion still in the womb in very severe cases).

Babies used to be monitored by looking at the bilirubin levels (a red blood cell breakdown product) in the amniotic fluid. This was done by amniocentesis, but this is not done very often these days due to the risks associated with amnio vs the non-invasive MCA ultrasound.

Intra-uterine transfusion in cases of Anti-E/e is rare. Most babies are born closer to term. Rarely (in cases of very high titres) they will require an exchange transfusion soon after birth. This removes the maternal antibody from their system and replaces their own "E" or "e" type red blood cells with cells from a donor which are compatible with the maternal antibody. Most babies born to Mums with Anti-E/e and moderate to high titres will have jaundice and will have treatment under the UV lights (similar to other babies who have jaundice for other reasons).

While it does sound scary, the OBs at the maternal fetal medicine unit that you will be attending really are the experts at handling immunised pregnancies. Don't be afraid to pepper them with a thousand questions. You will be in the best of hands.

edit- to make more sense (I think)

Edited by deejie, 06 March 2013 - 09:04 PM.





1 user(s) are reading this topic

0 members, 1 guests, 0 anonymous users

 

Australia's top baby names of 2013

Essential Baby has compiled the data available from government records around the country to bring you the list of Australia's top baby names of 2013.

Sara James: fighting for my daughter

Sara James was a high-profile New York journalist, but it was her own daughter's story which raised the most questions.

Siblings and best of friends

I know we'll have some tense moments. I know there will be arguments. But I also know these two will always have this most beautiful bond.

In defence of mums on the phone

I know news stories always attract a range of opinions, and I know they're a place for people to have an anonymous dig in. However, I also know that this mum bashing has to stop.

Rescue dog Zoey and BFF Jasper star in adorable pics

Photographer, self-professed "crazy dog lady" and mum Grace Chon takes photos of rescue dog Zoey and her 10-month-old son Jasper together. The results are just too cute. See more on Instagram @thegracechon.

Pregnancy essentials for the second and third trimesters

So you're through the first trimester of pregnancy - congratulations! Here are some tips for getting through the next six months as comfortably and happily as possible.

Coles Easter eggs recalled due to presence of tree nuts

An allergic reaction has lead to the urgent recall of a variety of Coles brand Easter eggs.

The ultimate travel stroller: the Mountain Buggy nano

We tried the Mountain Buggy nano and give it an enthusiastic thumbs up. As the ultimate travel stroller, it's practical, has great features, and looks fab, too.

Why I love the small age gap between my kids

Six months after our son turned one, we welcomed son number two into our lives. Yes, the small age gap had been planned - and there are things I love and hate about that small gap.

Parents warned about posting kids' photos online

Parents could be putting their kids at risk by posting images and information online which give away personal details, such as where they go to school and which parks they frequent.

Easter gifts for babies, no chocolate in sight!

If this is your little one?s first Easter you might want to mark the occasion with something a little extra special. Here are 10 Easter gift ideas, which won't harm little teeth.

Mum's the word when it comes to baby news

The arrival of a baby is big news, but friends and family need to understand it is not their news to share.

What?s in your parenting toolbox?

So often as parents, we don?t really talk about our ?parenting toolboxes?. But you need to be aware of what you and your partner are working with, and to decide what does and doesn't fit in your lives.

Classroom pregnancy prank goes viral

An American college professor has had to rethink his strict rule about answering cell phones in class after being the victim of an April Fools' prank that has gone viral.

Download now: Essential Kids Activity Finder app

Got bored kids? Quickly find the best activities for kids wherever you are in Australia with the Essential Kids app.

 
Advertisement
 
Advertisement
 
 
 

What's hot on EB

Win the brand new phil&teds vibe

Check out the good looking new release of the Vibe 3 and the Verve 4-wheeler inline strollers. To celebrate their release, we have a Vibe with double kit to give away.

Baby sleep

From birth to one year and beyond, read about baby sleep, soothing techniques, routines, and sleep school experiences.

Australia's top baby names of 2013

Essential Baby has compiled the data available from government records around the country to bring you the list of Australia's top baby names of 2013.

Video: Dad turns son into action movie hero

Many kids would love to be an action movie hero in real life, but very few will ever be able to see themselves in movies like these.

Toilet training in winter

There?s no need to stop thinking about toilet training just because the temperature is dropping: winter is a good a time as any to start the process.

What do you do all day?

It's the question all new mothers dread. For Kate Fridkis, it's a question that strikes to the heart of what it is to be a woman.

Easter gifts for babies, no chocolate in sight!

If this is your little one?s first Easter you might want to mark the occasion with something a little extra special. Here are 10 Easter gift ideas, which won't harm little teeth.

Video: Baby starts his day with a dance party

Few people start their day the same way this little guy does ? dancing, smiling, and generally having an awesome time.

IKEA announces bed canopy recall

IKEA has recalled its range of bed canopies designed to suspend above children?s beds following reported cases of injuries and entanglement.

 

Free Printable Activities

Keeping little hands busy

Free printable acitivity pages like colouring in, cutting, word finders, mazes, maths activities and puzzles.

 
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.