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Pregnancy

Talk about every stage of pregnancy, from early symptoms to preparing for birth.

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Original poster

Rh - women: Anti-D at 30 weeks?

34 replies

DomesticG0ddess · 25/08/2010 12:15

I am now 32 weeks and I missed this as the vaccine at 30 weeks as it had been sent to the wrong hospital when I went to my app, and I then went on holiday. I had the jabs after DS was born, and during that pregnancy. I have read that the vaccine at 30 weeks is not necessary unless you are in the 1% of women who have silent bleeds from the placenta, because if you had any noticeable bleeds/accidents, you would go straight to the hospital and have some anti-D. I wasn't keen on having the injection anyway, I guess that anything avoidable should indeed be avoided and I should just go and get it done.

But has anyone not had the anti-D at 30 weeks?

OP posts:

Are your children’s vaccines up to date?

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daisystone · 25/08/2010 12:20

Yes I thought that they only gave you the Anti D if you are Rh neg. Otherwise no need. I have got my 28 week midwife appointment in a couple of hours and it says that on my antenatal schedule. I'll see what she says today.

Original poster

DomesticG0ddess · 25/08/2010 12:25

Sorry, perhaps I wasn't clear - I am Rh neg. But my MW said that some people declined the Anti-D jabs during pg unless they had a de-sensitizing incident (eg. an accident or bump to your bump).

OP posts:

daisystone · 25/08/2010 12:36

Ah right. In that case - I'm not sure! Sorry....

coppertop · 25/08/2010 12:59

When I was pregnant first time around the hospital policy was only to give Anti-D to Rh- after the birth and when the baby's blood group has been found to be Rh+. I'm fairly sure this was also the policy for my second pregnancy too.

All 3 of mine have been Rh+ and everything has been fine.

ZoeC · 25/08/2010 13:04

I am Rh- and never had anti-d for either of my dds - their blood type was checked at birth from cord blood I think and I was told I did not require anti-d (so both dds must be Rh- as well). I was never offered it during pregnancy at all but this was a while ago now so I guess policy has changed.

excitedmummy2be · 25/08/2010 13:15

I had anti d at 9 weeks as I was bleeding. I was given it again at 28 weeks and told I didn't need it again until after I had the baby. To be honest I'm pretty confused about it all.... So actually probably not very helpful to you at all!! I don't think they explain the requirement for it in any way. I wasn't given the option to opt out though... They never said what would happen if I didnt have it. Arrgghh.... Confused myself even more now!

MissWooWoo · 25/08/2010 13:28

oh gawd it's a minefield isn't it? I am RH neg and had the injections after dd was born. I am very early on in a pregnancy and can say with hand on heart that if I make it past the first trimester I'll be taking any anti d they offer me as I'm a bit of a better safe than sorry paranoid worry wart

WhereTheWildThingsWere · 25/08/2010 13:38

I always refused the anti-d during pregnancy as it is a plasma product and I only wanted it if it were actually needed.

Both my dcs turned out to be neg.

Original poster

DomesticG0ddess · 25/08/2010 14:00

Thanks for your feedback. I was all set to not have it until I read about the "silent bleeds" - ie. I wouldn't know if there was a problem. Extremely unlikely, but still, so I don't know

OP posts:

mears · 25/08/2010 14:49

It is a difficult one. I personally had a silent bleed late in pregnancy with DS2 and then produced antibodies which affected DS3 and DD1 who were born agter that. DS3 was induced at 35 weeks due to rising antibody level and needed a blood transfusion when he was 6 weeks old. DD1 needed 3 exchange transfusions when she was born.

What happened to me is very rare. Should ALL Rh neg women get anti-D, a blood product injection, to prevent this rare occurance? I truly am not sure.

I do think Rh neg women should have their partners blood group checked prior to have what is possible an unnecessary injection. Also, if you are definitely sure it is your last baby then there is no need for it because it is for the benefit of future pregnancies, not the current baby. Not many women know that I don't think.

nowwearefour · 25/08/2010 15:04

i am rh neg and i declined it (dh is rh pos). i didnt want the risk of a blood product in me when baby was still in there unless i really needed it. one dd turned out to be rh neg and second one pos but i didnt have injection afyer dd2 as i didnt want any more dcs anyway.....

redandyellowandpinkandgreen · 25/08/2010 18:34

I'm trying to get DH's blood group tested as if he is neg too (unlikely I guess) then there is no need to have it. As it isn't standard practice it is proving difficult! We have had to register him as a blood donor instead and find out his blood group that way.

The midwife wanted to give me the anti-D at 28 weeks but I declined waiting for the results of DH's blood group.

Original poster

DomesticG0ddess · 25/08/2010 20:54

Yes, I did that last time, but he was Rh+ and I had the injections.

mears, so did the silent bleed not affect DS2, just the DC after him? I don't plan on having any more DC - I would be getting the jab for the baby I am carrying now and would certainly get it done if I had an accident or something like that. So if it possible to have a silent bleed that can affect this baby, I should just get it done, right?

OP posts:

excitedmummy2be · 25/08/2010 21:01

I think you should get it done. If you look it up the risk of any infection is so so remote. Someone got hep b or c in the 70's from anti d so it is now vigourously screened. Any risk to you is negligible and there is none to the baby. There is a small chance of a silent bleed... But from what I've read, that's higher than the risk from infection from the anti d. It's a tough call. X

mears · 25/08/2010 22:25

I had the silent bleed with DS2. He was nursed under phototherapy for a few days 'just in case' he developed jaundice, which he didn't. The silent bleed does not cause a problem really to the baby of the pregnancy it occurs in. The antibodies do not rise to a significant level. Phototherapy is usually all that is needed. It is the next pregnancy which will have problems if it is a rhesus positive baby.

gigglewitch · 25/08/2010 22:35

Probably irrelevant for me to post, I had loads of the stuff as I had bleeds in all my PG s and after mc as well. Is there any reason not to have it?

gigglewitch · 25/08/2010 22:42

I'm a walking antibody btw :-( and my dc had transfusions and were all badly affected with jaundice. The testing of the anti-d is rigorous as others have said. The small chance of that is far outweighed by the protection IMHO.

pooka · 25/08/2010 22:55

I declined anti-d in second pregnancy (ds1). First pregnancy resulted in dd (rh pos). I had anti-d postnatally. DS1 fine. All bloods fine. NO antibodies. Rh pos. Healthy and well.
With third pregnancy (ds2) I had the injections during pregnancy. He was born, Rh pos. I had the anti-d postnatally. But at a month was recalled to hospital as my bloods were showing levels of anti-d that were much greater than would have been expected. I have developed anti-d and anti-c antibodies, and carry a card in case I need transfusion. DS2 had haemolytic anaemia and had a blood transfusion with a day or so of the recall - very very low haemoglobin.

But he's fine. :) Didn't have jaundice. Liver fine. Perked up instantly (though I will never forgive myself for not having realsied he was unwell. He just started to get a little more sleepy and to me, had beautiful porcelein complexion As soon as he had the transfusion this network of scratches from his fingernails and the usual baby spots appeared).

So basically, my experience (which apparently is pretty rare) is that in the pregnancy I did follow all guidelines it all went tits up. Incidentally, my 28 and 32 weeks bloods during third pregnancy were clear of antibodies apparently. There's a possiblity that the blood exchange happened late in pregnancy, or at birth. But I just don't know - not sure about any bumps that would have been responsible. Birth less than 2 hours long. And in any case, surely the injections should have done the job?

pooka · 25/08/2010 23:03

And I still really wish I knew exactly what happened. I know in the general scheme of things it isn't that big a deal - ds2 is fine and all, and it was quickly and successfully dealt with. No harm done and all that.

But I still can't help obsessing about it and dwelling on it - was horrible at the time. And while I'd always thought would only have 3 children, I kind of feel like the decision has been made for me.

Really interested to read about your experiences mears. I remember when ds2 diagnosed searching mumsnet and your posts coming up.

mears · 25/08/2010 23:04

Out of interest pooka - did you have your antibody level checked prior to getting anti-D during your third pregnancy?

mears · 25/08/2010 23:11

Antenatal anti-D was not on offer routinely when I had my babies. Only if you had a bleed.

DS1 - anti-D post delivery
DS2 - antibodies found in my blood at 37 weeks. Gave birth 3 weeks later. He was in phototherapy for 3 days 'just in case' but did not get jaundiced.

15 months later had DS3. Antibody levels started to rise dramatically about 30 weeks. I was induced at 35+4 weeks due to antibody level. He needed ventilated for a week. DS3 had phototherapy but wasn't badly jaundiced. He had routine blood test when 6 weeks old and was found to be really anaemic. He was still feeding fine but was pale.

DD1 antibodies rose again about 30 weeks. She was monitored more closely by scan. Induced at 37 weeks to avoid ventilation situation. She became deeply jaundiced within an hour of birth. Had 3 exchange transfusions after birth in first 48 hours. Remained in phototherapy for over a week. Blood levels were monitored until she was 12 weeks old when her haemoglobin level started to rise. She didn't need any further transfusions.

snickersnack · 25/08/2010 23:28

When pregnant with dd, I told the midwife I didn't need anti-d because dh was also Rh neg. She said a) how did I know he was the father (yes, really) and b) why would that make a difference? After a bit of basic genetics chat she spoke to the GP who agreed it was best to avoid it if possible as it's a blood product. So I didn't have it.

pooka · 26/08/2010 08:25

Mears - that's a point. Thinks....

I'm pretty sure I had blood taken at booking in which was at about 12 weeks. Then again at 28 weeks.

So technically, if anti-d too high, then should have been noted prior to me getting the injection. BUt maybe wasn't noticed?

I don't know why but I've wondered whether the fact ds2 didn't get jaundice at all meant that the sensitisation happened late on.

INcidentally - my consultant said that anti-d not blood product any more, but synthetic.

pooka · 26/08/2010 08:39

And would the fact that have anti-c antibodies show that there was a sensitising event?

EMS23 · 26/08/2010 08:41

The anti D I received after my amnio was a blood product as the i.d. codes etc... are attached to my notes.
I never knew I could refuse to have it. I wouldn't refuse as I'm not concerned about the relatively low percentage risk but this thread has been really informative on a subject I've not really known much about. I've just gone along with what I've been told to do by the midwife!

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