Anti-Kell antibodies - help?

[Naomijay]

Hi all,

I was just contacted by midwife after a routine blood test (28 weeks) and she mentioned that my blood came back with 'anti-Kell antibodies'. She said its nothing to worry about, just something they will need to 'watch' in case I need a blood transfusion.

I've just googled it (yes I know - stupid idea) and have entered a world of panic seeing posts such as 'how my baby died of anti-kell antibodies' and other things about the baby needing a blood transfusion.

I'm O negative, don't know if that has any relevance and have had to have two AntiD injections following mild bleeding. Also I have to have a follow up scan in 4 weeks because my baby's 'rectum appears prominent' but have been told again not to worry.
This is my first pregnancy and I have never had a blood transfusion (I was informed by a helpful babycentre member that this could be a factor).

I'm still quite anxious. Does anyone know anything about this?

Anyone have experience of having it or know of any useful information sources?

[EldonAve]

www.rcog.org.uk/en/guidelines-research-services/guidelines/gtg65/

You should get a referral to fetal medicine

[ShangriLaLaLa]

Hello. I had this for my last pregnancy - out of the blue. Possibly the result of a previous transfusion. I found it a real shock and can understand how you may be feeling.

I found dealing with the (otherwise superb) midwifery team frustrating and they didn't really know what to do with me. I recall a lot of conflicting advice and stress. And as for googling...

However, my consultant requested my DH take a blood test to ascertain his Anti-Kell status, the results of this meant that the Anti-Kell would not be an issue for our developing DS. From the minute that we got the result of that test, no one mentioned the antibody status again and I didn't need my titres (levels) checked. Actually, it was mentioned again but regarding the possibility of a Caesarean, as that would require a special blood supply in stock.

My advice is to ask for baby's father to be tested. It's highly likely that the result would confirm no potential for problems. If however, the combination of your two antibody statuses had the potential to cause issues, fetal medicine will monitor your titres and keep a close eye on baby. A family member had this, her baby was scanned regularly and was delivered perfectly healthy.

It's five years ago now and I recall the panic and then the relief when the result made it all go away. For peace of mind, see if you can get your DP tested. Pregnancy is a stressful business and this could be one less pressure for you. I'm happy to answer any questions you might have although my memory (and my science) is a little rusty!

Very best wishes for the rest of your pregnancy.

[Tobyturtle]

I don't know if you've maybe see a specialist yet or not but thought it was worth me writing what I know about anti Kell antibodies. My sister in law had a baby coming up a year ago, in her 1st trimester she was told she had anti Kell antibodies. She was advised that her husband would need a blood test to ascertain the risk to the baby. Her husband came back as having Kell positive blood (which around 9% of the population have) Having Kell positive blood does not cause a problem for a person however when my sister in law had her last baby, he must have been Kell positive and when her blood got mixed with the babies during birth her body did not reginise the Kell protein that the baby had and her body created antibodies to fight the Kell protein.
This therefore means that now when her body comes into contact with Kell positive blood the antibodies fight it as they do not recognise it and want to get it out of her system.

By taking a blood test off her husband they could determine the risk factor to the baby. As I mentioned her husband did have Kell positive blood however you can either have a dominant or recessive protein. Basically if your partner has the dominant protein then the baby will definitely have Kell positive blood and if your partner has the recessive protein then there is a 50/50 chance of your baby having Kell positive blood. If your partner does not have Kell positive blood then the baby will not be affected and there will be no problem.

Her husband came back as having a dominant protein therefore the baby would 100% have Kell positive blood therefore meaning her body could potentially fight the baby as they recognise the Kell protein as a foreign body. To manage this she had to have regular blood tests which monitored her 'titer' levels. Your titer levels are basically the amount of antibody your body is creating, the higher your titer levels the more if a risk your baby is at as your body is fighting the baby. Unfortunately her titer levels were extremely high at each test, therefore she had fortnightly scans which measured the blood flow to the babies brain.

The way the antibodies fight your baby is by reducing the red blood cells to the baby therefore increasing the risk of the baby not getting enough oxygen. This can cause severe anaemia in the baby along with other problems. However although her titer levels were extremely high every scan came back as normal and she was induced at 38 weeks having a perfectly healthy little girl. If however the blood flow to the baby was reduced they would have given the baby blood transfusions whilst in the womb and delivered when they felt it was safe to (probably around 34 weeks).

I know it sounds very scary and to be honest the midwives do not seem to have even a basic knowledge however it is very rare for the baby to become ill of antibodies and as long as you are regularly monitored everything should be fine. I myself am 12 weeks pregnant and have just been told I have anti jka antibodies in my blood which is very similar to anti Kell and again stem from my 1st birth and so am similarly worried!

Just to also note you must have come into contact with Kell positive blood to have formed an antibody. This would normally be through a blood transfusion or through a previous pregnancy. You say you have no other children but have you had a miscarriage after 13 weeks as this would also be how you have come into contact with it? I have also read that rarely you can come into contact with it with immunisations however I believe this is extremely rare.

I hope this is a help to you, sorry it is so long winded, I am just aware there is very limited information available and so thought this may explain it.