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Pregnancy

Arguments for and against anti-D jabs

16 replies

PenguinArmy · 01/08/2011 07:38

Just wondering really. If anyone could provide info and link it would be much appreciated. Would be interesting in doing some more reading around the issue.

I know the general gist of anti-D/Rh -ve etc. so don't need a dummies explanation of the most basic part.

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benne81 · 01/08/2011 07:56

www.mcht.nhs.uk/documents/leaflets/10/mchrhdnegative09.pdf

Personally I think it is a complete no brainer if you are rhesus negative and you are pregnant - especially if you want more than one child or there is a possibility that you could become pregnant again. Your midwife should be able to provide lots of local information and counselling if you have any confusion.

nannyl · 01/08/2011 08:04

If you are -ve and so is the babies father, then i can see why you would say no thank you.

However if you didnt know for sure (ie Dads blood group, OR had doubts as to who the father was) and were a -ve blood group, then i think you would be mad not to have it, or even the think about not having it

PenguinArmy · 01/08/2011 08:06

thanks, I'm after more than that though

more specifically the 28 week jab, how long is it effective for etc. With regards to the pdf linked why that leads to no RhD present but not having it (provided the blood screen test shows none) has a 1-2% chance.

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WhereTheWildThingsWere · 01/08/2011 08:16

Not sure if it of any use, but I am neg, dp is positive, but I refused anti-d my second pregnancy as I didn't want to be given a blood plasma product as a precaution.

Both babies were born with a neg blood group.

Should ds (my first) have been positive then I would have had anti-d after having him, but I wouldn't adter dd as I knew I didn't want any more.

When I was pg with ds in 2007, there was no injection at 28 weeks, just after birth if the baby was positive, it is a very recent thing.

I certainly don't think it is a no-brainer, unless you are prepare to accept all that the medical establishment likes to throw at you, I think it deservers a little consideration, like all treatment.

PinkFondantFancy · 01/08/2011 08:16

penguin are you in an NHS trust that gives 1 jab at 28 weeks, or a jab at 28 then again at 34? Slight tangent but I was at Watford where they gave a '500' dose at 28 weeks which starts to decline by 34, which is why they give you another 500 at 34 which will start to decline by birth. I moved to Stevenage at 30 weeks pregnant and their protocol is to only give '1500' dose at 28 weeks so they've decided that they'll give me 1500 (rather than 500) at 34-this scares me quite a lot-how can they give me x3 the dose??? NICE guidelines are to give the split doses ie at 28 weeks, 34 weeks and after birth (if needed).

My MW lent me a book called 'anti d in midwifery' which has lots of background to the reasons for giving it but it's a bit heavy going.

PinkFondantFancy · 01/08/2011 08:22

This book looks at studies of sensitisation rates with routine anti d throughout pregnancy and without. Sadly none of them are properly accredited trials so don't hold any water with people like NICE but the conclusion was that while they will protect you against silent bleeds, the main benefit of them was that it helped healthcare professionals remember to consider rhesus factor after birth and in the event of any accident duing pregnancy (apparently they used to forget regularly...) and helped remind women of the importance of reporting bleeds. So it was the routine rather than the drugs themselves that was important.

I can't find anything official on the Internet that says how long the protection after each jab should last-I've only got what the hospital midwife told me to go on. I find the whole thing quite scary and they just seem to take the attitude of giving it to you without discussing any pros and cons-I hate being treated like an idiot like that.

benne81 · 01/08/2011 08:29

Yes of course it deserves consideration but essentially at the end of the day the medical community recommends anti D injection to protect the health of your unborn baby and they are not just throwing blood products at you for fun!

I personally think we should be grateful that we have this preventative option to prevent haemolytic disease of the newborn, something which women didn't use to have - with terrible consequences. I'm pleased that your DC's were negative but I personally wouldn't want to take the risk and I also find it hard to say never say never when it comes to future pregnancies - as these things aren't always planned!!

I suppose people have to weigh up the level of risk they are willing to take - its a no brainer for me. Speak to your midwife though - they are there to give you the most upto date info and advice and take your individual case into account.

benne81 · 01/08/2011 08:32

*never say never when it comes to future pregnancies - as these things aren't always planned!!
(sorry should have previewed)

PinkFondantFancy · 01/08/2011 08:50

Benne I don't think many people would disagree with you as far as having the anti-d after birth goes, but having it during the pregnancy as well is a bit more controversial. Especially since there is so mich variation in timings, dose levels etc.

Crosshair · 01/08/2011 10:28

I'll be having mine at 28 weeks, with any blood product there's a risk. My main reason for having it is the chance of future children is pretty high and my mums brother was extremely ill when born due to antibodies.

Good luck with making your choice and finding the research you need.

feckwit · 01/08/2011 10:35

When I was pregnant with my children, it was not offered during pregnancy, only after (unless you bled, then you got a dose which I did).

I had my dd1 and she was negative (I am neg, DH is pos). So no anti d required after birth. Then ds1 was positive so I had anti d after birth and then ds2 was positive but I didn't have anti d after birth.

dd2 was negative so no anti d after she was born either. During that pregnancy because I had not had anti d following ds2, they did discuss whether to give me a dose of anti d during pregnancy but had conflicting opinions. I found that there was a lot of conflicting advice out there and different health authorities all had different procedures which is complicated and gives out mixed messages.

Mmmmcheese · 01/08/2011 11:32

Crosshair - what risks are you talking about? I had anti D with my first baby and never questioned it - midwives and doctors seemed to view it as necessary rather than optional. What are the risks involved?

mousymouse · 01/08/2011 11:45

well it is a blood product. so there is a very small risk of contamination with viruses/priones. these products are screened as well as can be and they are pretty safe, but no blood product can be 100%.

PenguinArmy · 01/08/2011 17:21

well I am glad that I've got up to not just more and reckless statements :)

I am not in a UK trust yet, I am 29 weeks with my second. We fly to the UK today (getting picked up in a 3 weeks actually). I was supposed to have to the jab here but OB got called away and now there's no time.

I do agree with having it after birth and at sensitizing events but just got thinking about the routine pg jab, especially after hearing in some places it doesn't happen. I had a sensitizing event with DD, blood test confirmed antibodies and had the anti-D, so I'm not against and am grateful.

Still not any clearer on my train of thought though

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Crosshair · 01/08/2011 17:40

Yeah pretty much what mousymouse said. :) My booklet tells me the risk is very low.

PenguinArmy · 01/08/2011 17:42

3 hours not 3 weeks

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