Anyone know the deal with Rehsus D negative blood group?

[PotPourri]

I heard something recently that said that it is dangerous for your baby if you are negative bloodgroup and the baby is positive. Anyone know what the deal is with that? I'm B neg.

[SoupDragon]

If a -ve mother has a +ve child (only possible if the father is +ve I think) then she can develop antibodies to the RH factor which can then affect subsequent +ve children. The child can be born severely jaundiced when the mother's antibodies attack the unborn baby's blood.

The first born baby will (I think) always be OK and any -ve baby but any +ve child born after a +ve sibling can have problems. EG I was induced 4 weeks early and needed 2 exchange tranfusions at birth because one of my elder brothers was +ve. A blood product called "anti D" is given to rh-ve women to help prevent these antibodies developing in their blood and therefore removing the risk to +ve children.

Not very technical - there are plenty of RH-ve mothers on mumsnet who can explain it better! There have been a few threads on it.

[jellycat]

I'll start with the theory bit! If you are -ve and your baby is +ve then whenever there is a possibility of your blood mixing you can be exposed to the Rhesus factor on your baby's blood cells and start producing anti-D antibodies. Situations where blood can mix are: at birth, during certain procedures such as amniocentesis, if you have a bleed (for e.g. due to placental abruption) and during a miscarriage. The antibodies can cross the placenta and then attack the baby's blood cells. So, to avoid this, a blood product called anti-D is given to the mother after any of the situations listed above (expect for some early miscarriages). This immediately `mops up' all the baby's blood cells that are in your bloodstream and stops you mounting an immune response. You have to have this injection after every birth if you have a Rh +ve baby.

It is likely that everything should be fine for your baby. You will either be offered some anti-D injections or be monitored for antibodies to the Rhesus factor while you are pg, just to make sure. This should happen automatically because blood samples will be taken at one of your antenatal visits and your blood group will be checked and if it shows up as -ve they should do this (but it is worth remembering to check because things can always be missed!). When you give birth, the baby's blood group will be checked. If it is +ve then you will be given the injection again.

I hope all that makes sense! If you do a search you should find some more information on here.

I am O neg. and had the injection after my m/c and after the birth of my ds.

[coppertop]

I'm Rh-neg and dh is Rh-pos. Ds1 was Rh-pos so I was given the Anti-D injection after he was born. During my 2nd pregnancy I was monitored for antibodies but everything was fine. Ds2 was also Rh-pos and again I had an Anti-D injection.

[swanny]

I am rhesus negative too and what jellycat and soupdragon say is correct. I had some bleeding with my 2nd at about 12 weeks and they gave me an anti-D just in case and it was a bloody big needle! Doctors alway persuade you to give blood because it's rare - so you are special!

[Janh]

FWIW - my mother was -ve, father +ve, and they had 3 children. My mother always assumed we were all -ve because she had no problems with any of us. I think she had misunderstood the situation and thought that any +ve child causes trouble.

Anyway I eventually turned out to be +ve (was a big surprise!) so my brothers (one older, one younger) must both be -ve. (Have never checked but they must be...unless there's something she never told me...)

[littlemissbossy]

same here swanny i had early bleed and they gave me the anti-d injection and it bloody well hurt!!!

[mears]

janh - your brothers could be positive too. You don't necessarily need to have problems with positive children

[Quackers]

Hi, yes it;s generally ok and no problems occur. Some women need transfusions like soupy if it gets more serious, but they do pick this up. I've had about 5 anti D's now and they are a pain in the backside quite literally! Got my next one a week on Wed - urghh. I was worried as didn;t get an anti D when I bled this time as I waited too long. However they reckon 6 weeks was too early anyway and they wouldn;t have given it. Hoep they're right!

[mears]

Out of interest do you know your DH's blood group? If he is Negative you don't need any more anti-D.

[gingernut]

There was a thread about this a while ago, in which mears (I think) actually said that the bottom is not the best place to give anti-D, in fact it's more effective given in the upper arm (correct me if I'm wrong, mears). I've had it in the bottom twice and it didn't hurt much actually. I was advised to wiggle my toes - don't know if that made a difference at all. Unfortunately I think it's also down to the skill of the person giving the jab.

[mears]

You are correct gingernut - the most effective place for it to be given is the deltoid muscle in the upper arm.

[mears]

The wiggling of the toes is to make sure the sciatic nerve has not been hit causing paralysis

[bossykate]

mears, i'm glad you're looking at this thread. i'm +ve and dh is -ve and really can't decide what to do about prophylactic anti-D. shouldn't they only give it to me if i have been sensitised, i.e. have the antibodies present in my blood? although i have experienced sensitising events, i'm not sure i've actually developed any. are there any risks associated with having the anti-D prophylaxis anyway?

thank you so much you must get sick of being constantly on call here

[bossykate]

gah! i'm -ve and dh is +ve. roll on mat leave.

[gingernut]

Mmmm, that bit about the sciatic nerve is a bit scary

[Linnet]

I didn't know that either Mears. When I got my anti-d after my amnio they gave it to me in my hip and it was sore for days afterwards, the Amnio didn't even hurt as much.

Luckily haven't had any more anti-d injections since I insisted that dh be tested and was found, as we already knew, that he is also O neg like myself.

[bossykate]

anyone? please? or are there no clear cut answers to this...

[mears]

Hi Bossykate - the guidance is that any woman who is Rh neg should have anti-D at 28 weeks and 34 weeks incase she has a silent bleed.
Our unit has not adopted this policy as yet and the Royal College of Midwives do not support the mass giving of anti-D to pregnant women.

If you have bleeding or abdominal pain, you should have it then because you do not know if your baby is going to be pos or neg.
No-one truly knows what effects anti-D could have on the fetus in the long term.

[bossykate]

so if i have a bleed i could be sensitised and would therefore require the anti-d as i could have developed anti-bodies and we don't know sex of foetus? but what if i developed antibodies as the result of birth of ds1 (don't know his blood group) or m/c (but v. early - 6wks, so perhaps couldn't have sensitised me?).

are the risks to do with the safety of the blood products? why hasn't the RCM supported the NICE guidelines?

thank you v. much for answering my questions

[bossykate]

i meant "we don't know blood group of foetus"...

is alzheimer's a side effect of pg????

[emmagee]

Bossy kate, I am -ve and had anti-d after first 2 and was offered the prophylactic (sp?) this time for third but declined and just had anti d after delivery again, all my babies have been +ve. As I understand it, it's only subsequent pregnancies which are affected anyhow. On the subject of bum vs arm, this was the first time in the arm and it hurt like any other injection! But did ache more for a few days after than the bum one - or perhaps in the past the bum pain just got wrapped up with all the other rear-end aching!!!!

[gingernut]

BK, did you have anti-D after your ds's birth? (they should have checked his blood group and given you anti-D if it was positive. If it was negative then you wouldn't have had the jab). And do you know your dh's blood group? As mears mentioned, if he is Rh neg then you won't need anti-D. Re the miscarriage, when I had one at 11 weeks I was informed that policy at the hospital where I was treated was to give anti-D for miscarriages where the woman was 10 weeks or more. I think for early miscarriages the theory is that anti-D is not needed because the embryo's blood system will not yet have developed so you cannot be sensitised by it (hopefully mears will be able to comment more knowledgeably on that).

[Slinky]

I'm O Neg and DH is A Pos.

So when I was pregnant with DD1, I didn't have any Anti-D injections until after her birth when it was discovered that she a Pos. baby.

Then 2nd pregnancy - another Pos. baby, so Anti-D again.

With No 3, I started bleeding at 28 weeks and was taken in for monitoring. Was given Anti-D at that point as a precaution. After DD2 birth (at 42 weeks) was discovered that she is a Neg baby - HURRAH at least one like me , so no need for Anti-D that time.

All times have been given the injection in my thigh.

[bossykate]

thanks everyone. dh is o pos so there could be an issue. don't have the slightest idea if i had it after ds - after 43 hrs drug resistant labour was far too spaced out to have a clue! am finding it v. difficult to get my head round this one due to diminished mental capacity - pg related

[gingernut]

BK, you wouldn't have had it straight after giving birth. I had it a couple of days afterwards, once the results of ds's blood test had come back.