** PLEASE READ if you're Blood Group is RH NEGATIVE **

[looneytune]

Hi all

For those of you who have a RH Negative blood group, please make sure that if you have ANY blood after 12 weeks pregnant, that you speak to a GP or the relevant department at your hospital and ensure they know you are RH NEG. Ask them if you need an anti-d injection due to the bleed. Please also do the same if you have a bump without bleeding, just in case.

I wanted to highlight the importance of this due to the fact I had 5 tiny bleeds (just on wiping on the toilet) over a 13 day period before I was aware I should have been given an anti-d injection. I'd been to see 2 GPs who didn't question my blood group or mention anything about potentially needing to have a jab. Thanks to Mumsnet I was advised to call the hospital for advice and they said that yes, I should definitely come in and should have done when it all started.

I've now had these tiny bleeds 9 times and each time a new one happens after 72 hours since my last anti-d jab, I need to have another. So it's important that all RH Neg mums who have such issues, get an anti-d injection within 72 hours of any bleed. That is unless you are 100% sure that the father of the baby is a NEGATIVE blood group (as then your baby with be negative too and the issue is only if you are carrying a baby with a POSITIVE blood group).

I'm lucky that my blood tests haven't detected antibodies but the fact I went so long without an anti d COULD have caused awful problems.

This post is not to scare people, just to inform you as had I have known it's importance at the time, I'd have told the GP I was RH Neg and asked if I needed to have a jab!

[looneytune]

And before anyone jumps on me, I know it should be 'YOUR' in the title!

[JessicaMLH]

Thanks for the info! I am neg and nobody has ever told me this so definitely good to know!

[Leafmould]

Thank you for sharing this one, and good luck with your pregnancy.

[looneytune]

This is my 5th pregnancy (3rd baby) and I knew about needing one at a certain point in pregnancy, after birth or after a m/c if have an operation to help but never knew about bleeding in general so thought was ok as only tiny bits (and 2 GPs said nothing they could do). I've learnt that many others have had similar problems so I'm just trying to raise awareness of the importance! :)

[looneytune]

Thanks Leafmould :)

[fackinell]

Looney, just a quick Q as you seem to know about this, I am R neg and had anti D after the start of a bleed (3 days later I had a MC). Was told I didn't need another anti D after MC but have had 2 full on PG symptoms/late AF (but not to the stage of testing for BFPs) since. A bit confused about how it works as had no idea I was R neg until PG. maybe it's wishful thinking and my body created symptoms but I don't think so. The mth I thought I was I really hoped I wasn't as was waiting till after a hol for BFP.

[fackinell]

Oops forgot to add my Q!! Could the lack of anti D after MC cause future pregnancies to fail?

[looneytune]

fackinell - sorry about your miscarriage. I think you should be ok with not having the anti-d as they don't always give this if you miscarry under 12 weeks (presuming you were less weeks?), unless it is medically managed (i.e. D & C). Also, the fact you had an anti-d 3 days before the mc would suggest you were probably within the 72 hours anyway. Did they do a blood test at any point around the time of the mc or after? Or have they since?

Am I right in saying you feel you might be pregnant again now? If so, when is your period due? Keeping fingers crossed for you but try not to worry about the anti-d at this stage. When thy take your booking bloods they should include a test to inform you whether or not any antibodies have been detected. Where I am you get the booking bloods around 8 weeks and find out the results at your 16 week MW check. If you're similar, I'd phone and ask about the antibodies once the results are in to stop you wondering. But I'm thinking you've got nothing to worry about. Do keep us posted as to whether you get that BFP :)

[looneytune]

p.s. just so you know, future pregnancies don't have to fail if we do have antibodies, just that we need extra monitoring as baby may need blood transfusions and stuff like that but you would usually be put under consultant care and have a special care plan. But I'm sure this isn't something you need to worry about x

[fackinell]

Thanks looney, yrs it was a natural MC at 8wks. It was in the 72hr window as anti D on the mon, passed embryo on the weds. I had bloods done at coming up to the 8wk mark and my first check up. I dont think I'm PG now but in the past few mths I have symptoms on two seperate occasions. I fell so easily (6wks off pill) and nowt for mths since. I'm almost 40 so I'm expecting no picnic!! Thank you for your advice and yes I'll keep you posted.

[InNeedofSomeSleep]

I have the anti D injections coz I'm Rh negative and my husband and daughter are positive. All booked in for this pregnancy. Only thing i found with my 1st pregnancy I had the injection then went shopping and nearly passed out in the supermarket, they told me this time I'm not allowed to go alone. Was never told about anti d after miscarriage which I had a few years ago but it didn't affect my future pregnancy. Thank you for the advice about the bleeds to they don't give you much information about it.

[looneytune]

fackinell - that all sounds fine then so we just need you to have some success now! :) And 40 is nothing these days, good luck!! xx

InNeedofSomeSleep - wow poor you, they do say you're supposed to stick around for 20 mins after to make sure you don't react. I did feel a little woozy after my first this time round but as I'm having several now, my body is obviously getting more used to it as I've been ok since. Definitely worth having someone with you when you have them as you obviously react badly. Sorry you also suffered a mc, I don't think you need them under 12 weeks unless you are helped along (I had ERPC after mine so they told me they gave it me whilst I was still knocked out). But yes, they certainly don't give enough info out! They should make it clear that it's important we mention our RH status to medical people when we have a bleed as that makes a difference to how we are/aren't treated.

Hopefully I'll find out this baby's blood group by Wednesday and if I'm lucky enough to be carrying a negative baby, I can stop my very regular visits to the hospital! :)

[fackinell]

Thanks Looney, yes I'm obv still ovulating ok and it's all possible. Currently trying to lose weight as I heard just losing 10% of your body weight (I am overweight) can help. I'm on 5mg of folic acid daily as per midwife and trying to exercise. Thanks for your advice and good luck with your pregnancy.

[toomuchribbon]

looney, thanks so much for this. As you know from my falling-down-the-stairs thread I am too am RH neg (O neg) and this is so important.
Just a quick question if you have a mo - my hospital tested me for blood group with my booking bloods, although I already knew I was RH neg. But as far as I can tell there's no mention of antibodies or not on the results, so I don't know whether I have them: presumably you still have to have the anti-D regardless, as I have, but should I know about the antibodies too?

And congrats on your pregnancy by the way - didn't realise you were currently pregnant too! (doh).

InNeedofSomeSleep, poor you! How horrid to have that happen in the supermarket. Funnily enough I had exactly the same, though at least was still in my midwife appointment at the time - got up to be weighed, could suddenly barely stand and then couldn't breathe! Cue crash bell sounded, consultants from next-door foetal med unit rush in. After half an hour or so I was fine, just utterly embarrassed - especially after the lead anaesthetist asked whether I'd eaten breakfast that morning, and put it down to a vasovagal reaction ie embarrassing old faint following bloods taken from each arm and the anti-D: I still maintain it was just the anti-D! I've never reacted to something before but pretty sure this was a reaction - it felt so specific and I have no prob with jabs/bloods etc usually.
At least we know for next time! My midwife said to have it given lying down preferably on left side next time, and to stay like that for 45 mins or so. Best of luck with the rest of your pregnancy : )

[looneytune]

fackinell - thanks and best of luck to you :-) x

toomuchribbon - yes it's important so I'm pleased you got seen, even without a bleed as you have to be careful! My booking bloods are listed in my hand helds notes (full blood count, blood group, antibodies, rubella, syphillis, hep b, electrophoresis, HIV & MSU) and next to antibodies it just says NIL which is good. Antibodies are then routinely checked with a blood test at 28 weeks and there is a box for that (I'm not at that stage yet). If you'd have had antibodies detected they would have told you and put you under a consultant and you'd have been monitored a lot more often (or at least this is what SHOULD happen). They would NOT give anti-d to someone who has antibodies as it wouldn't help. The anti-d is only given to stop your body creating antibodies if yours and baby's blood have mixed and this is only effective if given within 72 hours of that happening. I'm therefore lucky that I didn't have a problem after a 13 day wait and 5 bleeds, obviously the bloods didn't mix at that point so my body didn't start producing antibodies. Sorry you also had a bad reaction! I haven't had that with the anti d but I had a specia blood test done recently where they took about 8 viles of blood (so we know this baby's blood group) and thank god I was lying down as I went funny and she got my husband to lower he back so my head was right down, she said my blood pressure suddenly dropped as when I felt funny, my blood also stopped coming out (which then made me think about what was being done and I felt worse - I hate blood!! lol)

[scissy]

however, I'd like to add that it is possible to get a positive result for antibodies if you've had an anti-D injection close to when they do the blood tests. This happened to me this pregnancy - I'd had a bleed (but they knew I was RH- from previous miscarriage) and gave me anti-D, the day before my routine 13 wk appt was due! I had a positive result, with a note saying it was probably due to anti-D. They ended up having to repeat the test at 28 wks when it had gone back to negative.

[looneytune]

Very good point! Before my first and second Anti Ds they took blood to check for this and I had the anti d anyway. I guess if they'd have come back as antibodies detected they'd have known they shouldn't bother with not anti d with future bleeds as no point. I think they might have done a Kleihauer test (I believe confirms if there has been a mixing of blood) with the first too but I'm not sure as they don't usually til a long further gone (just might have because of the length of time between bleeding and getting the jab).

[InNeedofSomeSleep]

I'm surprised they have never said anything to me because I have a problem with my heart to. (think I'm falling apart!) my sister is the same as me and she told me loads about it thankfully (she researches everything) were both AB-. Glad I'm not the only one the injection didn't agree with, thought it might of been my weird body. DH was away with work through my 1st pregnancy but he will be here this time and come to every appointment with me.

[looneytune]

That's good you with have DH with you :)

[looneytune]

Just bumping to make sure people stay aware :) x

[blondecat]

A good reminder



Just to add you don't need it after every bleed if they are within a max 6 weeks window from your last shot. But depends how pregnant you are - past 20 weeks it could get more frequent.
The anti d is effective for up to 6 weeks. Otherwise I would be having them daily. Having said that many obgyn's are not that up to speed or at least mine wasn't. He thought it could wait till 24 weeks after the initial shot at 7

You can find the British hematology institute guidelines here. See section 5
www.bcshguidelines.com/documents/Anti-D_bcsh_07062006.pdf

Let's all have happy safe pregnancies

[LalyRawr]

I had the Anti D at 14 weeks, after a bleed. At 28 weeks because they said I had to and again after I gave birth as my critter is positive.

If I get pregnant again do I have to have the shots again or will it be ok now?

[MaggieMaggieMaggieMcGill]

Laly, you'd still have to gave them. I tried that with my second pregnancy, said I was never intending on having anymore so was it really necessary, the answer was yes, just in case I changed my mind.
it's four years later now and I still have no intention of ever having another child!

[blondecat]

Laly

Yep. If you have a small bleed you do as your current pregnancy could be sensitized. And if not you do because they wanting to be sure

It's not a nice jab is it? I find it quite unpleasant. If anyone had told me I would be badgering doctors to give me shots I would have said they are crazy but now

[looneytune]

Interesting blondecat as my hospital insist that it's only effective for the first 72 hours so I did have to keep going in, they said it was to do with what they see in the lab from the blood results and the dose. I've no idea if they were just being over cautious though?

Luckily I no longer have to have them thanks to finding out this baby is 99.9% rh neg too, phew! I'm lucky I have a very senior consultant and saw him yesterday, he told me that the blood test I had done cost £259 and they don't normally do them but they were worried about the fact I had 5 bleeds over a 13 day period before any anti d was given as my blood showed my blood had mixed with baby's! We are all relieved I don't need to worry but he said it could have been a different story had baby bee positive thaks to GPs not saying anything about my blood group! Although this blood test was expensive, if I continue with these bleeds every couple of days, I worked out that having anti ds say twice a week for the rest of the pregnancy would have cost them approx. £780 so saved them a lot of money with baby being rhneg

And yes, you need them for each pregnancy as you don't usually know what the baby's blood group is (unless you are 100% sure baby's dad is a negative blood group too in which case you wouldn't need them). I had to have one after ds2 as he's positive. I thought he was the last but 4 and half years later, my surprise happened and I'd have been so upset if I'd risked that due to my body now having anti bodies. So yes, always best to be safe :)

I was told by the consultant, health care assistant and midwife that I was a very 'interesting' case and that they had lots of departments awaiting my results from the special blood test - even the department who deal with transfusions had been asking the consultant what was going on with me. I'm just pleased that his blood group means I'm low risk (as long as bleeds remain small) and I'm still on for my homebirth. Now to complain to the Drs Surgery to make sure this mistake doesn't happen again!