Antibodies questions, Mears are you around?

[lljkk]

Anyone else welcome to contribute, too, of course.

I am 16 wks into 4th pregnancy...I was reading old threads and saw you had anti-K antibodies in pregnancy and that you're also a MW.

Blood tests in early pregnancy make my nausea much worse, so I skipped them. Blood tests in late pregnancy worry me because they become an excuse to be stabbed again and again (doesn't help I always react badly to any blood taking) to verify iron levels. And then nagged and assessed whether iron levels are good enough, etc.

With my blood group (AB+) Rhesus factors not an issue, but I worry about the rare antibodies, anti-M, anti-K, maybe others I don't know about.

I can't even find any stats to say how common rare antibodies are in pregnancy. Some websites say that only women who previously had blood transfusion are at risk, others imply that any previous pregnancy is a risk factor.

Do you know stats on frequency? Am I right to think that there's simply no way to figure out if I'm at risk of rare antibodies without some type of blood test?

I see Mears is around today...

She's not ignoring me on purpose, isn't she?

They are quite rare but there is no way of knowing for sure if you have any abnormal antibodies without having a blood test.

I was quite glad that I'd had those final blood tests last time as it was discovered that I have a low count of anti-E antibodies which it's thought was as a result of a blood transfusion I had in 1979. The result was that DS was jaundiced at birth.

If you don't have the tests done (my arm gets progressively painful having them done, but I know it's needed) you won't know and can't prepare.

They will need to do a 'group and save' blood test anyway in case you were to need a transfusion and it should be picked up then or if you've ever given blood then they would know. They would then test the babys' dad for their blood group and know what the risk would be.
I have anti-kell antibodies resulting from a blood transfusion - has to be that rather than my MC as DH is Kell neg, but they still wanted routine bloods doing every 4 weeks from 12 weeks, then 2 weekly from 28 weeks. As I told my MW, my antibody titre didn't increase because there was nothing to trigger a reaction
Most of the obscure anti-bodies leave the baby at a slightly higher risk of jaundice, rather than the much more severe problems you get with Rhesus incompatibility, so DS was tested at birth. He did go a bit yellow by day 5, but that was due to the really bad weather and not seeing much sunshine in June and he didn't need any treatment for it.

Hi,
Im not really sure if i am in the right place or not but i was wondering if anyone had some information about anti-E, Im 16 weeks pregnant with my second child and have anti-E with a titer score of 16, not sure really if that is high or low. I see a specialist on the 18th so in the mean time im stressed and confused i need some info, i've never had a blood transfusion and my blood type is A pos so i dont even know how i got anti-E, Can someone tell me wat to expect during this pregnancy and is there anything i can do to ensure the baby will be ok... thankyou

Bee, I haven't been able to find out much about anti-E on the web and all my GP said about it was that I didn't need to worry too much. I know that the count goes from 1 to 32 (but I had a count of 2 in my last pg, not sure what it is this time atm (am 18 weeks now) ) so 16 is bang in the middle.

Your consultant will be able to give you more details.

They will monitor you all through so you'll probably feel like a pin cushion and, I think, that if necessary they can even do blood transfusions for the baby before it's born without too much difficulty. The other thing I was warned about was that the baby might be jaundiced. DS was and so I'm working on the assumption that this one is likely to be too. Nearer the time I'll do a lot more research into it so that I am well armed with info when we see the Paeds after it's born but from what I understand, bf, and particularly colostrum, is the best way of clearing it.

Clicked post before I meant to! Shall we set up an anti-E bit on the pg board?

Good luck anyway Bee and let us know how you get on.

Oh, thanks for the other replies!
I've never had a transfusion, which seems to remove risk of certain antibodies. It's just the Kell ones I don't understand.

Bee21, here's an academic paper saying that titer levels below 1:32 are ok (not to worry, below the threshold for intervention) for anti-E. Different consultants might have different cut-offs, but 16 still sounds relatively good, so far.

wow, i cant believe i got such a great response so quickly, I've been everywhere trying to get some sort of response from other people on anti-E but never even got a reply,This site is awesome thanks heaps, i guess now all i can do is cross my fingers, find all the information i can and try and enjoy being a pin cushin for a while... I've been told by my gp that i will need that needle in the belly at around 25 weeks along with monthly u/s and bloodtests im not realy looking forward to it but if thats wat i need to do then i will do it. Pigeonpie, i look forward to hearing more from you and how things go during ur pregnancy...
Thanks guys.

Pigeonpie, sorry i did ur trick (lol). I think thats a great idea to set up an anti-E bit on the pg board, i wouldn't know how to do it though im kinda not great with computers, but im getting there slowly!

I've never heard of anti E/K, can someone let me know why you would develop those?

I'm off for my first anti D on Monday - I'm severely needle phobic but been doing all sorts of things to make sure it's not a disaster this time. An injection is marginally less scary for me that a blood test.

However, they have said they'd like more blood from me which i don't think i can cope with (the booking bloods were an 8-hr disaster/fiasco ending in me being given a general anaesthetic) in case of 'other' antibodies being present.

Does anyone have any useful information?

sorry i cant really be of much help as i have anti-E and i still dont know how i got it, on the net it says that usually it happenes when the mothers blood is neg and the baby's blood is pos and at birth ur bloods mix then u develop antibodies, they say that having the anti-D needle thing will prevent this happening, u can also get antibodies in ur blood if u have had a blood transfusion... in my case my blood type is
A RHD POS and i have never had a transfusion so i would realy like to know how i got anti-E as well, hopefuly i can findout some more info at my visit with the specialist on the 18th and i'll keep u posted... Hope all goes well at ur appointment and try not to stress to much about the needles, as it does have to be done... goodluck

hi

i am 16 weeks pregnant and was wondering if anyone knew about anti kell anitbodies last week i found out i have positive anti kell and i am o neg blood type the father is b positive and this is my fourth pregnancy so do not know where these antibodies came from.

the father have been tested for anti kell but i am still worried about this as anyone had this or is this very rare and has anyone had a healthy child from this happening to them.

I see a consultant in two weeks time and they will tell me everything i need to know but i still am very nervous as to what will have to happen next and whether or not my baby will survive i have read quite a lot on the internet about anit kell and a lot of babies did not survive.

please help!!!!

I think anti-Kell is very rare and I think Mears (the MW who posts on MN, whose attention I was trying to get) had one or more pregnancies with Kell antibodies (and the babies were ok at the end). So she's doubly qualified to comment.

I think.

I imagine being O- with a B+ partner you had Rhesus D jabs in previous pregnancies, didn't you, Sarah2578?

Hi I developed anti-C and anti-s antibodies while pregnant with my second child and was told that sometimes we develop these antibodies when giving birth to first child and blood crosses the placanta. And because maternal blood is quite sensitive, it causes these antibodies to develop.

My bloods were regularly tested during my ante-natal care but DD ended up with severe jaundice requiring two complete exchange transfusions in the neonatal unit.

Has put me off having a third child.

The anti-C antibody was only picked up on the day I delivered (was three weeks early and anti-C was picked up at the antenatal appt before I popped later that evening)

thanks lljkk

i did have all the anti d shots but after having all three last babies i did not need them after birth as they must have neg blood too and my mw does not know how i can have devloped this anti kell anitbody it really is confusing and very difficult to get my head round it all.

My DS was my 3rd pregnancy, but only one to term, with the other 2 needing D&C and I had a transfusion after the first.
I also was one of the last babies born in the UK before the anti-D treatment, so needed a complete blood change at birth, so had 2 whole tranfusions then.

I am O pos Kell neg, DH O neg Kell neg, so my Kell antibodies must have come from one or other of the transfusions. If I had had a different partner, then the Kell sensitisation could have come from losing the other babies as some foetal blood may have reached my circulation during the surgery.

My DS was absolutely fine, even though they did keep taking blood from me 4 weekly from booking to 28 weeks, and then 2 weekly until he was born at 38 weeks. The antibody titre never changed, well it wouldn't as nothing to trigger it. He did have a high Hb 22.something at birth and they took 2 lots of blood from him to check for neonatal jaundice, but he was fine and did not need any treatment other than being left under a sunny window, which took some finding in June this year

Hi vole3, you seem to know a bit about these antibody things so am i right in saying that ur titre should stay the same unless something happens to trigger it to rise?

That is correct. For the titre to rise, and cause a problem with a pregnancy, there has to be some mixing of foetal with maternal blood and there has to be a discrepancy between the two that the mother is negative for a group and the baby is positive.
The first time causes sensitisation and the next time the problem happens - the sensitisation can occur during MC or delivery or as a result of transfusion. Usually it's only the Rhesus incompatibility that gives most problems, so they make sure that emergency transfusion units are O neg ie 'universal donor' and would type match anything else if given enough time.

my titre level is 1:2 is that ok and does it depend on the fathers anti kell status as to what will happen with my pregnancy.

or am i at more risk because of my rhesus status being negative

please help

Hi sarah,

AS for your titer, i think 1:2 is low and as vole3 was saying the titer should stay the same throughout your pregn as long as there is nothing to trigger it to rise and now that you already have the antibodies i dont think the father has anymore to do with it unless your doc recommends phenotyping as for the blood type im not sure it realy matters if you are neg or pos, now that you already have the antibodies, im not absolutly sure so if im wrong someone correct me please...

Hope you can find the information you are looking for as it is scarey not knowing or understanding the medical jumbo out there.

Goodluck sarah have a great day...

I went yesterday to see the consultant and my partners blood does not have anti kell in it so that means that my baby is less likely to have them too and as for my level she said its not a problem so i should sail through my pregnancy now. I am going for a detailed scan to make sure everything is ok in three weeks time and i just need my blod taken at 28 weeks as they would normally for the anti d check anyway then she said she would see me again to check eveything is ok

im glad everything is a ok, I go for my first doppler scan tomorrow to see if the anti-E is affecting my bub, i also have to get another lot of bloods done to see if my titer has changed in any way,Im crossing my fingeres and preying all goes fine and im hopeing i can sail through my pregnancy too ...lol...

Hello again,
so much for sailing through with no hiccups!
i know this is an old thread but i dont know where else to go,lol. I got my blood results back the other day and my titre is rising and now i not only have anti-E i also have anti-c, Has anybody had this happen to them and could somebody give me some advice as to what i should expect.