URGENT ADVICE NEEDED - RHNEG, 12 weeks pg, hospital called to say contaminated blood............

[LOONEYplayingachristmasTUNEy]

Hi there

Had a fall on Tuesday, nothing bad but phoned midwife to ask for advice and she offered to see me on Friday at drop in clinic. Baby's heartbeat heard so felt reassured but when I told her I was RHNeg blood group, she said I'd need a blood test as fell after 12 weeks (12+1) to see if baby's blood had contamintated with mine. Told me to call back on Monday for results.

Just getting ready for going out in few hours (xmas meal an hour away, me and dh booked in at hotel) when the phone rings.....hospital calling to say I need anti-d injection as it IS contaminated. I said when do I need it and they said TODAY or TOMORROW . I then said ok, I'll cancel my plans and loose money if baby is at risk which she agreed and then I worried and said 'but I fell on Tuesday' and she said 'OH' and then said 'oh, don't worry, it's future pregnancies that are at risk'.

So now I'm confused. Is THIS baby at risk? Is it just future pregnancies? should I be worried that I haven't had anti-d until this weekend? I'm currently waiting for them to rush some Anti-D to the ward as they don't have any atm.

I just want some FACTS. I knew all about anti-d etc but didn't know that a slight fall in pregnancy could require it etc. I'm so confused and dh is in a state about whether or not he should continue and go to the xmas do anyway? (lots of money spent )

TIA

Bump for you as I don't know.

Hope all is okay.

Can you not go to the hospital now and still go out later?

Cheers NAB - they've told me not to go yet as the injection isn't on the ward. It's a long story as to why I can't really go tonight (dh was supposed pick his bro up at 2pm to bring him here and we were supposed to leave at 3pm, now i have to call hospital at 2pm to find out when to go in)

Is this your first pregnancy?
And am I right in thinking you were 12+1/40 on Tuesday?

3rd pregnancy, 2nd child. Was 12+1 when fell on Tuesday, now 12+5

It does all sound a bit mixed up.
However I think overall they are going by your blood test which might show you have antibodies which might be harmful to the baby, therefore you should have the Anti-D to mop these up.
They might be assuming that your small fall caused a small bleed of baby's blood into yours, however sounds quite unlikely. 12 w is the magic cut off ie if you had been under 12 weeks no anti-D ,as over needed blood test.
Overall the reading seems to be if in doubt, give the anti-D, which may be what they are opting to do
Am off to read up further as has been a long time since I knew all guidelines, will be back, with some more definitive answers

the worry behind the fall
Fetal-maternal hemorrhage can occur due to trauma, abortion, childbirth, ruptures in the placenta during pregnancy, or medical procedures carried out during pregnancy that breach the uterine wall. In subsequent pregnancies, if there is a similar incompatibility in the fetus, these antibodies are then able to cross the placenta into the fetal bloodstream to attach to the red blood cells and cause hemolysis. In other words, if a mother has anti-RhD (D being the major Rhesus antigen) IgG antibodies as a result of previously carrying a RhD-positive fetus, this antibody will only affect a fetus with RhD-positive blood.

So they are giving you anti-D for future pregnancies, but I wonder if your bleed test already showed anti-RHD IgG antibodies as a result of a previous pregnancy.
It seems they got a little more worried with your blood test result seemingly

i thought anti d had to be given within 72hours?

or am i wrong?

Yes , recommended within 72 hours, but I suspect that's why they are keen to do it today

But then routine ANti-D at 28 and 34 weeks seems to recommended to pick up any sensitisation that may have been missed from any point in the pregnancy, so the 72 hours may not be as hard and fast.
If you have had previous anti-D, I think that can also interfere with your blood results, but I dpn't know if that would be anti-D from previous pregnancies or not.

thanks everyone, on my way to hospital now

Good luck with it all

Thanks and sorry I disappeared. It was a mental rush after the 'are we aren't we' going away and when we decided to go, it was all systems go to get their as was at the hospital about an hour (I asked lots of questions!)

Well, I got there and was in a ward where you normally go after baby is born (cots etc). Then a lady came in to give me the anti-d and I asked if she'd be able to answer my questions and she said 'well, this leaflet tells you about the anti-d' and I explained it wasn't good enough, I had actual questions about what's happened and the fact I didn't get it within 72 hours etc and was confused as to whether this baby or just future pregnancies were at risk as a result. She said she'd get a midwife. Midwife came in asking me to explain everything as she knew nothing about me. I explained and she went to speak to a Dr. She came back and said the reason she knew nothing about me was because I was on the wrong ward, I should have been sent to the Gynaecology ward as under 16 weeks pg. But as I was there, she was sending a Dr from that ward to see me. He came very quickly and answered my questions before giving the anti-d to me. He explained that my baby's blood had come out and leaked into mine and because my baby is positive and I'm RHNeg, my body will fight the baby/baby's blood? and therefore I need the anti-d to fill my body with anti-bodies which will stop my body doing that. This baby and future pregnancies were at risk without it. I asked if it mattered that this wasn't done within the usual 72 hours and he didn't seem worried. I did say I was concerned about whether my fall caused this mix of blood or something else as the fall was only slight and also, it happened at only 12+1 and they don't do anything unless it happens after 12 weeks so I may very nearly have not been checked yet needed it. He did reassure me with his explanation but me not being medical, I can't remember it all. I suppose I just have to trust what he said but I wish I understood more about it all. I'm still not 100% sure if I got the anti-d after my son was born or whether it wasn't needed because of his blood group? I've had a bad feeling about this pregnancy from the start, had slight early bleeding, not felt pregnant, just got the tummy but no feelings yet heart is beating so I should feel reassured. I did feel more reassured after hearing baby's heartbeat on Fri and recently having a scan of baby looking like a baby (not a bean like in the early days) but I'm starting to worry again about the unknown, wish I could just forget about it all but I can't shift the bad feeling! Anyway, I've just got to take it easy he said and if I have ANY trauma, pain or bleeding, I have to go in each time and have an anti-d (or check to see if needed).

OK - Here's my understanding of ANTI D (i'm RHNEG too)

The fall thing is for this and future preg to stop your anti bodies attacking the baby.
They will give you another one at 28 weeks (make sure your MW makes that apt at hosp, as I had to go to hosp after my MW apt and wait for 3 hours!!)

When the baby is born, they will take some of your blood and some of babys cord blood, do some kind of test (I think to see what blood grp baby is and whether they've mixed) and then depending on results will give you an Anti D injection again.

I had an Anti D around 13 weeks cos I bled slightly, they said they couldn't see that it had mixed but were going to give it anyway just to make sure.

HTH.

Cheers for that, I didn't have blood test after ds was born and don't remember the anti-d either, just that I had the injection to bring on placenta. They certainly never mentioned anything about checking ds's blood - was all a big rush tbh at the time, under staffed I think. All I know is that the test I had on Friday showed baby's blood HAD mixed so presuming it's from my fall?

p.s. my appointments for 28 and 32 weeks were done on Friday so that's sorted - they never did this when pg with ds, no anti-d's at all back then (5 years ago)

Assume its from your fall and don't worry about it, Chances are they'll keep an eye on you anyway cos of the fall - I know I had an extra blood test cos of the bleed I had.

I'm sure my MW was just abit dull with my 28 weeks apt (never had a 32 week one) I went into my docs to have my MW apt and then she realised I should have had an injection as well so off I went to hospital. 3 hours sitting in a room on your own is no fun!! lol

What a PITA!

I'm getting more and more confused after reading stuff on the net. The official sites basically say that once your body produces the antibodies, that's it??? The Anti-D injections are to stop your body producing these anti-bodies which is why they say you should have it within 72 hours. Well I had bleeding at about 6 weeks and am now concerned as although I was told didn't need anti-d unless this happened after 12 weeks, others were given it at 7 weeks etc I'm now unsure whether my baby's blood mixed with mine earlier than the fall and if so, is my baby now at risk as had the anti-d too late??

Just babbling aren't I, sorry, just thinking out loud (plus secretly hoping someone really knows the answers)

Looney - when you had your bloods done at 12 weeks did they tell you whether you had any antibodies detected then? I'm Negative too, but I'm sure the midwife told me that no anti-bodies showed up on my test ( I also had a slight bleed at 11 weeks which is all over my notes and nobody has referred to it - I assumed as before 12 weeks).

Just been to check my notes as did not want to mislead you - my rhesus D neg report thingy definately says 'antibidy screening test - negative' - so this might be on yours too??

I'm RhNeg and both dcs are positive.

With dd, was given a shot of anti-d after the labour, once they knew she was +.

With ds, had 3 blood tests: one at 14 weeks, one at 26 weeks and one at 32 weeks, I think. Each time they were checking to see whether antibodies were being produced. Now by the time ds was born, they had introduced general preventative injections of anti-d as a routine. So should have had 3 lots.

But I opted out, on the basis that each bloodtest I had showed no anti-bodies. But obviously had another injection after he was born.

If I were you I would definitely ask for clarification.

looney policy had changed recently according to my last midwife. with dd1 2005 i had a bleed at 16wks and thats when i found out i was rehsus neg i then had few others and after birth. this time i didnt have as many shots but still after birth.its easy to get confused on internet as there are other types of this. best thing is to ask midwife to avoid any more upset andconfusion for you

This is all I could find.

"Fortunately problems are rare these days because of the use of anti-D (Rh) immunoglobulin to prevent sensitisation to rhesus factor. An injection of this immunoglobulin is given to the mother soon after the birth of a rhesus positive baby. It acts by mopping up any of the baby's rhesus positive blood cells which have crossed into the mother, and destroying them before they sensitise her.

If given with 72 hours of birth it's 99 per cent effective in preventing sensitisation.

Little risk in this pregnancy

This means that there's probably little risk to you or the baby from rhesus incompatibility in this first pregnancy. Your blood should have been checked to see if you're producing antibodies to rhesus factor at the first antenatal visit (all pregnant women are checked at this time).

You may be checked again at 28 and 36 weeks of pregnancy. Whether or not these tests are normal you need to be vigilant about your health like every pregnant woman. If you're making antibodies, you and your baby may need special care for the rest of the pregnancy.

After the delivery you should ensure the doctor at the hospital is aware that you're rhesus negative and you're given anti-D.

If you become pregnant again you should be protected if you've had anti-D, but those looking after you will probably want to test your blood at regular intervals to check for production of antibodies against rhesus and may want to do occasional extra checks on the baby just to be sure."

Now from reading this, and your OP, it sounds as if the blood test you had showed that you had produced anti-bodies. I would have thought, but am no expert, that given that you weren't tested after your ds was born, that the antibodies were produced as a result of his birth, rather than the fall. And that the anti-d would therefore be given routinely throughout the rest of your pregnancy and that that should be sufficient to "mop up" the antibodies.

Am amazed that they didn't do a blood test after your first labour. My dd is 4.5 and was certainly something that was done as soon as she was born and the midwife visited within 72 hours to give me the injection. Which obviously worked because had no antibodies throughout my second pregnancy (thankfully as ds also positive).

Sorry to go on..... but do call your midwife if you need clarification. She should be able to reassure you.

Wow, thanks for all the messages. Just in the middle of making dinner so will be quick but will be back

Quick question..........on the Midwife Notes, I've just looked at the Booking Bloods section where it has hb, blood group etc. There is a word that says 'Antibodies', would anyone here know for SURE if this is relating to the RHNeg factor and whether or not the body has produced these antibodies for attacking???? IF this IS what it means, I feel a lot better as next to it it says NIL which means at 8 weeks I was fine therefore it IS likely to be the fall that caused this problem, or at least something after 8 weeks (been having horrible thoughts that it's from when I had ds and that my body had been fighting baby since the start).

Thanks

I can't think what else that could mean. Trying to think back to my own notes when was pregnant.
Having looked back at the sort of timeline of what you've been told and when, I still can't work the damn thing out! You'd think I'd remember....
Best to chat to the midwife I think, just for more info/reassurance.