Antibodies in blood - Rh Negative

[Mumtobe193]

So I'm currently 20 weeks pregnant with DC no 2. I'm Rh negative, never had any problems in my first pregnancy, had anti D after I gave birth, DD was Rh positive but all was well.

In this pregnancy however it's not been quite as straight forward. I had a couple of instances of bleeding at 11 and 15 weeks, had anti d both times. Had my booking bloods done at 14 weeks but was called back in for a re-test. Turns out they found antibodies in my blood but they thought it was due to the anti d still being in my system. So had more bloods on Monday, got the results today, came back as still having antibodies, only a different kind of antibodies this time which is unlikely to be related to the anti d?

Midwife booked me in to see a consultant who specialises in this type of thing next week. She said I would probably need some extra scans and monitoring, to check baby's okay, but didn't say a whole lot on the matter. Between now and next week I'm going to worry like crazy wondering what all this means for my baby. I've heard about rhesus disease and have read up on it and I've scared myself silly. I just want my baby to be okay.

Anyone else Rh- and had a similar experience? What was the outcome? Could I be worrying about nothing or is there potentially serious cause for concern?

Can you ask for the NIPT to be done? It will check babies blood group as if they are RH negative there is no risk to them. Some NHS trusts are offering it but not all and it’s expesnive privately.

I'm A- too! Baby is A+ because DH is.

Not had this but did have issues in my last pregnancy and learnt the hard way NOT TO GOOGLE IT!!! You'll work yourself up over nothing and Google will convince you you'll die no matter what. Honestly, Google 'I have an itchy nose' and it will tell you it's because you have nose cancer or something deadly.

Stay away from the Goog.

Stay calm. You've been referred to someone who does this for a living and will deal with cases like yours every day. They know about you and are monitoring it. It's not gone undetected. They'll put a care plan in place to keep both you and baby safe. Be that extra scans or whatnot.

Congratulations on your pregnancy!!!

If it helps I am an adult result of a rhesus disease pregnancy without anti d. I was born 7 weeks early and had to have a blood transfusion/ an extended hospital stay but I'm still knocking about

Here's hoping the specialist midwife can give you some clearer information and help you to feel more at ease. I've never googled it but just wanted you to know that even worst case scenarios can turn out ok X

@Buggeroffbingbunny I'm going to ask the consultant next week if they can do that. They might even suggest it. What are the odds of the baby being Rh- too? 50/50? I really hope he is to save all this worry :(

Really confused as to how I can have antibodies in my blood? I had the anti d after every instance of bleeding? And during my first pregnancy and after her birth? And I've had no traumas around the tummy area? I had a MC at 6 weeks pregnant in April but was told an anti d wasn't necessary after losing a pregnancy so early on, so it couldn't be related to that could it?

On the bright side, I had my anomaly scan today and baby looked absolutely perfectly healthy ..

The odds are less than 50/50 of a RH negative baby’s.

You partner must have been RH positive if your DD is. There he is either ++ or +- and handed down a +.

If you are RH negative you are - - and handed down a -.

The +- always creates RH positive as the + is dominant. This is why your DD is RH positive.

Therefore this time round you will definitely hand down -, but your DH could hand down a + or a -, and it’s more likely he hands the + as there are 3 of them as possible outcomes rather than 1 -.

Hope that makes sense.

Although anti D antibodies are the most common there are many other antibodies that can also be found on booking bloods, some of which are more significant than others. At this point Dr Google is definitely not your friend, wait until you speak to the consultant and they will explain what the antibodies are and what they may mean. Depending on what the antibodies are they may need to take blood from the baby’s father too.

Hi OP
I’m gonna watch this thread with real interest because the exact same thing has happened to me.
I’m 38 weeks though now.
I had a miscarriage at the beginning of the year but was told I didn’t need anti-d.
In this pregancy, I’ve had spotting at 5-7 weeks, 11 weeks, 15 weeks, then a significant red bleed at 21 weeks and then more spotting every week since 34 weeks which they’ve now suggested is being caused by abit of cervical erosion. I’ve been given anti-d every time since the 15 week one.
I had the anti-d at 28 weeks as standard and then at my 34 week midwife appt, another midwife (mine was away) noticed a letter from the hospital (which my midwife had missed) saying that they had found antibodies in my blood. Some code similar to C+c-E+e-K or something like that and that I should have been having blood tests every 2 weeks to check for changes in my blood.
So now they’ve been doing that but nobody seems to really know what they are doing or looking for. Some people have said that it could be the anti-d that they are finding in my blood, others don’t have a clue. One midwife told me all it means is that if I need a blood transfusion myself then it will be harder for them to match my blood group (I’m A-) and match the antibodies too. Every blood test I’ve had has come back with no new information then the last.
I’m so fed up. No one seems to know what they are doing. One letter suggests that my baby will need to be thoroughly checked over at birth but from the care I’ve received, I won’t be surprised if it gets totally overlooked by everyone unless I mention it myself.
Sorry to ramble on x

They have already taken bloods from my partner today @MadameJospehine

@Buggeroffbingbunny yes that makes perfect sense, thankyou

@MagicalCreatures your situation is almost exactly the same as mine. I'm also A- aswell. I'm so sorry this wasn't picked up on until so late on in your pregnancy. Fingers crossed everything will work out okay for you and your bubs!

@Mumtobe193 well I’ll let you know if I have any luck with anything or get anymore information from anyone. So atleast you have an idea of what to expect.
Quite honestly my midwife has been dreadful and the other midwife couldn’t believe that she had overlooked this very important letter saying I needed the fortnightly blood tests from 28 weeks.
Good luck with yours too. X

That’s good mumtobe193 some types of antibodies only become relevant if partner also has them so hopefully by the time you go to your appointment they’ll have his results back too and will be able to give you clearer information

@MagicalCreatures thank you. Hopefully you finally get somewhere and get some more info.
I'm just glad I'm seeing a consultant about this next week, because quite honestly my midwife doesn't seem to know very much about this whole Rh- business. I'm just happy she's referred me to the consultant so I might finally be able to get some more solid answers.

I'm just flicking through my notes now trying to make sense of it all. Anyone know what anti-Kpa positive means? Or what HDFN stands for?
In my notes it says, 'the antibody is clinically significant and may cause severe HDFN'
The words 'clinically significant' and 'severe' really worry me. I just have no idea what HDFN means?

Gosh this doctor I'm seeing next week is going to be bombarded with questions, lol.

I googled HDFN. This is what and up
www.nhs.uk/conditions/rhesus-disease/
It all sounds really serious but the reason I think maybe they are being more cautious with you is because this isn’t your first pregnancy.
I’ve been told before that if this baby (my first) is of a positive blood group and he’s blood mixes with mine, then it shouldn’t affect him as such but if my blood makes antibodies because of it, then it will affect any other pregnancies and babies after this one.
Whether that is true I don’t know.
Maybe that’s why your notes sound more serious then mine. Maybe they are concerned that you made antibodies in your last pregnancy so it puts this one more at risk. Though you said that your last pregancy had no complications?
Will you let me know what the consultant says next week? X

I have had 3 anti-kel antibody pregnancies for which there isn't even an antidote. Baby 1 , no issues. Baby 2, closely monitored, slight anaemia issues after birth but nothing dreadful. Baby 2 5 x intrauterine blood transfusions every 2 - 3 weeks from about 20 weeks. Weekly monitoring. Super high risk pregnancy. Born 5 weeks early after intrauterine transfusion failed. Perfectly healthy baby turns 14 tomorrow!! Moral of the story is my very bad case scenario actually wasn't that bad. Trust the doctors. You'll be high high risk and closely monitored but they can do amazing things! x

I'm Rh- and I've had 3 girls all Rh+ thankfully

@Desmondo2016 so best case scenario a perfectly healthy baby (although with this being my second DC its pretty unlikely) worst case scenario, blood transfusions. Or maybe just slight anaemia? It's reassuring to hear that despite your baby going through the worst possible scenario they've grown up perfectly healthy.

As silly as it sounds and as insignificant as it is in the grand scheme of things, I hope i don't get classified as 'high risk' in light of this because I really had my heart set on a water birth in the MLU, especially after an awful highly clinical birth with DD. But ultimately the most important thing is a healthy baby and of course I will do whatever the professionals advise.

Sounds like your antibodies may be unrelated to your rhesus status. Being RhD negative is very common and straightforward. It’s normal for anti D to be detectable in your blood for some time after having the injection. You can however have different antibodies eg Anti M, Anti Ro, Anti E etc. which need to be monitored closesly during your pregnancy. It sounds like this may be what they have detected in your blood. You will likely get some extra scans and blood tests.

Experienced in this...

This is your first affected pregnancy, so in theory the outcome should be less serious - generally the antibodies increase with exposure in each subsequent pregnancy

In short - whether it’s d or any other antibody (kell, c, C, G etc) if you have developed the antibody it can attack the baby’s red blood cells via the placenta. This can cause anaemia in the baby.

The NHS will do a few things - firstly they’ll monitor the levels of antibody in your blood. There’s defined levels for each antibody at which it is more likely to cause an issue - although this is just a guideline and some people with very high levels end up with unaffected babies and vice versa. Then, if your antibody levels reach the threshold, you will be referred to a fetal medicine consultant and they will scan you at regular intervals - to analyse blood flow through the middle cerebral artery of the baby. This is an effective way of seeing signs as to whether the baby is showing any anemia (blood flows at a different rate). If the baby does start to show signs of being affected they will - depending on your gestation - either carry out regular blood transfusions in utero to the baby or deliver the baby and treat after delivery.

There’s a NICE green top guideline - management of women with red cell antibodies in pregnancy - which you’ll want to get familiar with.

In terms of your antibodies - d is related to being positive or negative blood - you’re negative and your partner is positive. Anti d injections aren’t 100% effective so there is always the possibility of developing anti d as a d negative mother. For other antibodies there is no preventative treatment in the first place so any mixing of your blood with the baby’s blood whilst you are pregnant means you can develop antibodies.

My second pregnancy (first affected) with 3 antibodies resulted in an EMCS at 34 weeks and my baby was in NICU and had a blood transfusion and other treatments. She’s fine now. My third pregnancy has been monitored but it looks as though this baby has my blood type and therefore shouldn’t be affected.

@NoisePollution Thankyou for taking the time to share that information. X

I'm A- and DD is A+. I ended up having a c section for various reasons but the consultant I spoke to said that given DDs blood type this was probably for the best as there is less risk of bloods mixing than with vaginal birth. This might be something to consider and discuss at your appointment depending on your feelings about a planned c.

It's reassuring to hear so many positive outcomes. I'm worried about the prospect of TTC DD2 when we feel ready due to this but it sounds like it's mostly been ok for everyone.

On the above - if you already had the antibodies then worrying about further blood mixing due to mode of birth isn’t worth it

Fee free to PM me if you have questions

@NoisePollution I thought the same, if the antibodies are already there, then having a c section won't make any difference

Just an update for anyone who's wondering ...
Seen the consultant this morning, he said I actually have quite a low level of 'Kell antibodies' I think he said? However they want to get me in every couple of weeks for blood tests and scans until I give birth to make sure baby's okay and my antibody levels aren't rising. Had a scan today, doctor checked the blood flow coming out of one of baby's arteries in the brain, apparently this can indicate HDFN. All looked normal, doctor was pretty chilled about the whole situation, although I am now classified as high risk, so there goes my water birth in the MLU, not a big deal in the grand scheme of things, but still, I'm a tiny bit gutted. Oh and also, still waiting on OH's blood test results, they basically want to know if he is Kell Negative, if he is there is a 50/50 chance the baby will be completely unaffected by the antibodies.

Anyway, all seemed well for now. Baby's fine, doesn't seem to have any signs of HDFN, and I'm going to be scanned every 2 weeks now so if something changes they will know about it fairly quickly. I can relax a littl bit over Christmas now

@Mumtobe193 that’s really good news. So pleased for you.
I also, funnily enough, got a little bit more Info about my situation yesterday.
After seeing yet another different midwife who was 10x better then any of the others, she found more stuff in my notes from one of my hospital visits (coz of the bleeds I’ve had) from a doctor that said I should be referred to fetal medicine.
She couldn’t believe that this hadn’t been done and that I’d been given no info on any of it.
She called them and we have now found out that, thankfully, the antibodies they have detected in my blood is looking like it is just from the anti-d injections and the 2 weekly blood tests I’m having are checking to make sure it stays that way. Apparently if my blood shows an increase in levels of over 7.5 then that would indicate it wasn’t just the anti-d.
It has stayed below that.
But what a palaver. All that worry and yet not one person could tell me the results from my bloods or what on earth they were looking for. X