Type D Antibodies at 29 weeks - Help!

[babypowder]

I found out today that I have type D antibodies in my blood despite having prophylactic Anti D throughout my last pregnancy and after birth. I can only assume that the antibodies weren't in my booking bloods so there must have been a sensitising event sometime during this pregnancy.
Of course, this being a Saturday, I won't hear from the medical team until Monday about my ongoing monitoring and treatment regime. I've managed to get myself into a right tizz about this and can only envisage the worst case scenario .
Have any other RHNeg mums been through this?
Sorry if you've seen this posted on other threads ...

I know mears had pregnancies with this. I am rhneg and hoping this won't be a problem for me if I have another child. i think extra bloods and scans are the order of the day. Good luck and I hope someone more useful is along soon!

OK, management will depend upon your titre levels, ie; what the level of antibodies in your blood is. This will be monitored closely thru the rest of your pregnancy.

Occassionally if your titre levels get too high they may want to deliver baby early.

After birth the cord blood will be checked for serum bilirubin levels (high levels can cause jaundice). They would also probably want to check baby's hameoglobin level to ensure not anaemic. But fingers crossed your titre levels will remain low. How many weeks pg are you?

She's 29 weeks (says so in the title! ).

duh, its been a long day

I'm sure they'll be able to tell you more as they will know your titre levels. Try not to worry, chances are everything will be fine.

Know the feeling Binka.

Thanks for that FreakyFloss and Binka. It's been a long day for me, too (even without this I feel like I'm wading through blancmange at the moment!)

Actually - if I could ask one more daft question.

I had an anti-D injection stratight after the blood was taken for the test that shows the antibodies. Will this have any impact at all?

Really must stop dwelling and get some sleep!

Bumping for you, BP. Hope you get that sleep! xx

I don't know. Hope that someone does though so bumping!

bumping

No the injections wouldn't have any impact. The ant-d is meanto "mop-up" and destroy any fetal red cells that find their way into your circulation. The anti-d needs giving within 72 hours of the fetal cells entering your bloodstream. However your body has now made antibodies against the fetal red cells, so its too late for anti-d to have any affect - it doesn't work against your antibodies. Does that make sense?

OK, I'm really confused now. The consultant from the Blood Transfusion Service told me yesterday that I would need regular (fortnightly) scans and blood tests to check titre levels and for fetal anaemia. My midwife then spoke to the OB consultant who has said something quite different. She doesn't feel that there is any significant risk to this pregnancy, and that I only need to get blood checked monthly. Only subsequent pregnancies would be at risk.
Like I said, I'm completely confused - can anyone help?

babypowder - I myself developed antibodies in my second pregnancy at 37 weeks. That baby was not affected but he had prophylactic phototherapy for 5 days post delivery.

Firstly do not panic. You will require to be monitored throughout this pregnancy and it may well be that monthly checks are enough. Your obstetrician will know when to recheck.

Don't assume there weren't any antibodies in your booking bloods. Ask what the result of your booking blood test was. It may be that they were there and not followed up (I have seen this happen).

The prophylactic anti-D may possibly affect the initial titre level but that will 'wear off' if you like. It will not have any effect on the development of your own antibodies.

That said, what will happen is that you titres (levels) of antibodies will be checked. Depending what the level is, monthly may well be fine. That is what I did. It was my third and fourth pregnancies that were more severly affected. DS3 was delivered at 35 weeks because of rising titres. Unfortunately he needed ventilated for a week. DD1 (no. 4 ) was delivered at 37 weeks in an effort to avoid prematurity. She needed 3 exchange blood transfusions. Both children are absolutely fine, aged 16yrs and 13 yrs respectively.

Can I ask how you managed to speak to the blood transfusion consultant? That is pretty unusual.

Also, did you have any bleeding episodes in early pregnancy this time?

Thanks for all that info, Mears! My records with BTS show no antibodies at booking. I did have 2 small bleeds at 7 and 12 weeks (before boking bloods were taken and these shouldn't have an impact on production of antibodies apparently). I haven't had any accidents, or fallen, or anything so I can only assume that I've had a silent bleed at some point after 12 weeks.
The records held by BTS showed that I had received anti-D at 24 weeks and 28 weeks, so they assumed that the antibodies were passive anti-D. I practically had to scream at them to make them understand that I had only 1 dose of anti-D at 28 weeks. Like I said, if the (male) consultant had ever had an anti-D injection he would know that it isn't something you forget
So, after a weekend of Google-induced terror, I shall now relax and leave it in the hands of the professionals . It's so reassuring when you hear of other mums in the same boat who have had positive outcomes. Thanks so much.

babypowder - anti-D should be given following bleeds from 12 weeks onwards - that could be the source of your antibody production. I was wondering whether you had passive antibodies hence the question.

You didn't answer my blood transfusion consultant question BTW - did you call him?

Will post a link in a mo regarding anti-D

standard guidance for anti-D prophylaxis

Sorry for the confusion Mears - I didn't speak directly to the BTS consultant - all messages were ferried back and forth by my poor midwife! By the end of yesterday, I think she wished that I had spoken directly to the consultant (as do I, frankly). Thanks for the link. YOu are a godsend!

@babypowder hey hun , what was outcome of this as I have exactly the same situation and going out my mind with worry x