Rhesus Negative Injections

[guyshahar]

Hi

My wife is rhesus negative, and this is her first pregnancy.

The midwife told us that there was an option to have an injection to prevent any reaction in the case of a mixing of blood between the fetus and my wife, and that this would also help be beneficial if there is a second pregnancy at a later date.

The midwife told us that there were 2 options : to have the injection pre-emptively, or to have it if and when a mix of blood occurs. However, she was unable to explain the advantages of each approach, saying only that in the past most people had the injection if a mix occurred, and now most people have it pre-emptively.

Could anyone explain to us what the consequences of each option would be?

Thank you.

[TrippleBerryFairy]

I haven't heard about the 2 options from my midwife. I am also rhesus negative therefore did a bit of reading - in this case 2 injections are needed- one around 28 weeks (which I have had already and feeling perfectly fine) and another one after the baby is born. I asked the midwife whether the injection affects the baby in any way, she said no, the injections are to prevent problems with the 2nd baby in the future. NHS leaflets also say that in case of mother being rhesus negative, there are 2 injections.
Not quite sure what you midwife meant therefore cannot say anything about the consequences, sorry.
To me it seems a pretty straightforward matter - one injection at 28 weeks and another one after the baby is born.

[puffylovett]

Hmm, I had both with my first DS. One at 28 weeks, and I THINK another after birth although I can't say 100% for sure.

I thought that would be it, to prevent probs in 2nd baby.

However with this pregnancy I'm told I have to have it 3 times ... new standard procedure ?

[mears]

guyshahar - do you know your blood group? If you are rhesus negative your wife does not need any injections.

The problem can occur if you are rhesus positive which may mean that your baby is rhesus positive. Prophylactic (preventative) anti-D injections were introduced on the basis that some women have blood mixing in their pregnancy that they are not aware of (silent sensitisation) and antibodies are formed which affect the baby of a next pregnancy if the baby is rhesus positive. The baby's blood group is checked post birth and if it is rhesus positive anti-D is given again. None is needed if baby has negative blood group.

Anti-D is a blood product that is thought to be safe currently.

[mears]

Currently there is a move to give a larger single dose at 28 weeks and then post birth if needed.

[mears]

info here

[Bucharest]

www.mumsnet.com/Talk/pregnancy/747385-Rhesus-negative-can-I-just-have-anti-D-injection-AFTER

This was a recent thread about the injections.

[pavlovthecat]

I was never given an option of if and when. Mine was pre-emptive at 28 weeks. This was the only option i was given. And if baby was positive, another one would be needed post birth. DD was negative so not needed, but this means I need another injection this time around.

I personally would prefer pre-emptive. There is enough stuff to worry about with pregnancies, especially first ones, to worry about the possibility of a bleed and mixture of blood would be too much for me. Why wait for the risk if we can stop it from happening in the first place?

[nannyj]

I have just moved from London to Norwich and in London 3 injections were needed at 28, 34 weeks and after the birth but in Norwich they just do 2 injections at 28 weeks and after the birth. I've not had a problem at all with mine.

[WhereTheWildThingsWere]

Don't want to say much as I have been flamed in the past.

Just wanted to point out that you can refuse these injections if you wish, anti-D is a blood plasma pruduct and so carries all associated risks.

Personally I would never have anti-D unless it was actually needed. Luckily despite my dp being positive all my babies have my blood group and I am glad I refused the jabs.

I am not suggesting you go this route, just reminding you you can.

[mears]

pavlovthecat - do you know your DH's blood group?

[mears]

WTWWTW - your baby's do not have your blood group only - they have the rhesus negative componenent from your husband's positive group. He must be heterozygous positive which means he can father both rhesus positive and negative babies.

I personally am uncomfortable with a blood product being injected in pregnancy which is for the benefit of a future pregnancy, not the current child. It wasn't an option when I was pregnant and I do have antibodies which developed in 2nd pregnancy. 3rd and 4th babies needed treatment but are fine.

[WhereTheWildThingsWere]

I meant thay are the same blood goup as I am (a neg) not that they only have my blood.

[wasabipeanut]

I had quite a lot of bleeds due to cervical erosions in my 2nd trimester with my ds so I had lots of anti d shots in addition to the scheduled ones.

My ds turned out to be O+ like my dh so I am glad I did.

Guyshahar - you will be doing your wife a big favour if you find out what blood group you are! If you can save her from a few dates with a needle I am sure she will thank you!

[chaya5738]

It is not the case that the injections are only for the benefit of a future child. They are also given in case you have a bleed during the first pregnancy or during the birth in which case your blood may mingle with your child's and your body will start producing anti-bodies to attack the fetus. Personally, I think refusing to have these injections is taking too much of a risk with your baby's life. But I understand that some people have difficulty intelligently balancing risk and prefer to say no to all medical intervention.

[WhereTheWildThingsWere]

Thanks for that chaya5738, if only I could be as intellegent as you, ah well best go check on the kids playing with matches in the road.

[drowninginclutter]

DP was checked and was + so I had the injections. I think they were 28, 34 weeks and after DS had been tested (he was +) when he was born.

I think it's generally considered safer to have them during preg because you could have a small bleed without being aware of it.

Definitely worth getting yourself tested if it might save your DW having unnecessary injections. Apparently some health authorities don't automatically test partners though as it can lead to complicated questions

[dal21]

Totally agree with other posters. Get yourself tested. Although where we were, they werent allowed to test DH as once they say the woman is rhesus neg, they want her to have the injection.
Reason? Due to increasing cases where the 'supposed' father has not actually been the biological one.
We got his bloods done privately and he was +. I got the jabs (I think) around 28 weeks and post birth.

[dal21]

Oh and reasons for. What Chaya has said, plus not having it can also put future pregnancies at risk. The aim of the injection is to prevent your wives blood treating your childs blood as an 'invader' and as such making antibodies to remove them. They basically aim to prevent any of these antibodies being produced. I intend to have the anti-d with this pregnancy also.

[MustHaveaVeryShortMemory]

Chaya: How did you intelligently balance the risks?

It must have been hard as there are no long term studies on the risks (to the foetus) of anti -d during pregnancy.

[verytiredmummy]

I had two injections during my first pregnancy but didn't need the third one because my boy is rh- like me.

I'm now pregnant again - will I need them again, or is it only for first pregnancies?

[hedgiemum]

My DH knew his blood type was O-negative, but even so I have been hassled every pregnancy, including in labour, to accept anti-d. I understand that this is a tricky area for experts as it would be very hard for a woman in labour to admit in front of DH if there was a chance he wasn't the father! But its not like partners are at every midwife appointment (or any, in our case!) and there would have been plenty of opportunities for me to have had it if I had any worries.

This pregnancy (my 4th) I have written on the front of my blue notes and on the top on my birth plan "I do not need anti-D as baby's father also RH-. I will not accept a prophylactic blood product for which I have no need." So far, no one has hassled me!

[twinklegreen]

verytiredmummy you will need them again.

I'm on dc3, had one after 1st was born (not during pregnancy as it wasn't offered then), had one at 28wks and one post birth with 2nd. This time I've chosen not to have one at 28wks (I think it is unneccessary, in many area's it's not offered so it can't be that vital. If you have any bleeding you get one anyway)but I will have one post birth if this baby has +ve type blood. The consultant was a bit stroppy when I said this is what I had decided but if they give you a choice I think they should at least respect what you choose to do!!

[Momtobeof3]

I am RH- too! I usually get the injections at 28 weeks and after delivery...I feel its the best way then to actually chance the blood mixing and having a higher rate for miscarriage the next time! Go with the series of injections!

[pavlovthecat]

Mears - not 100% and they won't test him on the basis i might not be being truthful about the father of my unborn child . As we asked for him to be tested, save all this fuss each time. But he is AB blood group so likely + and he is pretty certain he is a positive.

[olivo]

chaya, please be aware that some areas do not offer prophalactic anti-d, so some have no choice. I hope they are not taking risks with my baby's life