Blood groups - jaundice

[Zuzi]

Hi, I was wondering if someone out there could give me some advice on this. I am 0+, my husband is A+. Our two children are A+ and as a consequence they both were quite badly jaundiced shortly after birth - ABO incompatibility. They both received intensive phototherapy and we had to stay in the hospital for a week until the bilirubin levels settled.
Currently I am pregnant with our third baby and I am wondering: is this baby going to be A+ (I understand that the likelihood is really high) and more importantly if it is A+, is it inevitable that the baby will be jaundiced due to ABO incompatibility?
I would really like to have a homebirth this time round. The above is not a reason not to but I will have to prepare myself for a hospital stay after the baby's born.
My midwife appointment is not until mid August and I thought I would ask if someone can shed some light on this. Thank you.

I don't know anything about ABO incompatibility but I read this and found it really interesting. I'm A+, DH is O+, I have no idea what DS is. When DS was born he was jaundiced, I was home when it developed and they kept an eye on him, we didn't end up back at the hospital luckily.

Have a free bump and I'm going to lurk, 30 weeks pregnant and wondering too if it'll be an issue this time.

Hi, as far as I understand, if you are A+, it is highly likely your children will be A+ too. So the jaundice was probably not really caused by ABO incompatibility, it was milder, therefore no phototherapy needed.

Hiya, my DD had ABO incompatabilty when she was born only mildly so didn't need phototherapy but did need a week in hospital.

From my understanding (which only applies to my case) I'm O-, DH A something, DD A- and she developed the incompatibility due to me tearing at birth so our blood mingled. From the small amount of research I've done it is not definitely going to occur with future pregnancies unless our blood mixes again and baby's blood group in an A. Hope this helps :)

It depends on your husband's genetics - if he is homozygous A (ie both copies of the gene are for blood group A) then your baby will definitely be A also. If your dh is heterozygous A (ie one gene codes for A and the other O) then there's a 50/50 chance that your baby will be group A. Do you know what blood groups his parents were? If either of them were blood group O then he will be heterozygous.

I think you would be best speaking to your obstetrician or possibly a neonatologist if you can, about whether this baby will be affected - I don't know a huge amount about this, but I think that the chances are fairly high, but as you know it is very unlikely to be severe.

My daughter was seriously ill with ABO incompatibility and we were told that there wasn't much point talking about "if" our next baby would be born with the same condition as the chance was unbelievably high. The doctors explained, however, that it's entirely treatable and that I would have a consultant-led next pregnancy. Fast-forward 6 years and I did have a consultant-led pregnancy but DD2 was born without the condition. We had to stay in hospital for a few days for observation but no jaundice appeared and she's now a bouncy 4 month old! Good luck!

I am O- and my husband is B+. Both my DCs are B+ and were treated with 5 days of phototherapy for jaundice due to ABO incompatibility. I'm pregnant again and have been asking the same questions as you to my consultant.

The consultant told me that the guidlines have changed now (we're in Scotland) and that affected babies don't automatically require the 5 days of phototherapy. Instead, they monitor the bilirubin levels and see if they need it at all. Sometimes they will only need a day or so followed by folic acid and sometimes just folic acid.

I have requested that cord blood is taken as soon as the baby is born so that we know the blood type and the bili levels asap.

I'm preparing myself for a week in the hospital again, but hoping that it won't be needed this time round.

BTW: you can work out the percentage likelihood of your baby being A+ if you can find out if your DH's blood type is homozygous or heterozygous. If your DH is AA then it's 100% likely that the baby will be A+. If DH is AO then it's only a 50% chance that the baby will be A+. You can find this out by a blood test on DH, but my NHS trust were unwilling to do it as ABO incompatibility is unlikely to cause serious problems.

Thank you for your replies. I'll have to find out about my husband's blood group in more detail.
My pregnancy is midwife led so far and both children's bilirubin was monitored after birth daily to see if the levels required 5 days of phototherapy. It did. hence my question.