MEARS - you able to help with a question about Rh-ve and Anti-D given after 72 hrs after trauma?

[LOONEYplayingachristmasTUNEy]

Hi Mears, I spotted you on another thread and would love to know if you know the answer to this. Long story short...had anti-d after the recommended 72 hours after baby's blood mixed with mine. Is my body likely to have started to produce anti-bodies or is it hard to know?

TIA

It is highly unlikely becaue you have had anti-D injection.

How do you know the baby's blood mixed with yours? Did a test tell you that/ If so then the test advised how much anti-D to get.

Out of interest, do you know what the baby's dad's blood group is?

Anti_ can be given up to 10 days after incident by the way, though recommendation is 72 hours.

Thanks Mears, that's really reassuring Basically had a fall a week ago Tuesday and went in for a casual check on baby on the Friday. When midwife knew I was rh-ve, she decided to do a Kleihaur test just in case and the next day the hospital phoned me and got me straight in for an anti-d. They said to me that my baby's blood had leaked into mine and that my baby's blood was +ve. I've since been told (on MN) that a Kleihaur test wouldn't show whether or not the baby had +ve blood and that either they told me wrong and should have said baby's blood MAY be +ve or that they did antibody screening at the time and it did show antibodies and therefore they knew I needed anti-d. I must say it's all very confusing!!

Dh is A+

I have read about the 10 day thing, just nothing confirmed it was definitely ok, should that it CAN be affective for up to 10 days. I was lucky my midwife tested me as the hospital had told her she didn't need to bother but she did anyway!

The kleihauer test picks up the baby's haemoglobin (FHb)in the mother's blood stream which is how they can tell that there has been a mix of blood.

It is most likely that they said the baby may be positive.

If you had developed any antibodies you would not have been given anti-D, because the purpose of anti-D is to stop antibody formation in the first place. It coats the fetal cells so that the body does not recognise it as something foreign, thus preventing antibody formation. HTH.

They DEFINITELY said the baby WAS +ve, heard it twice however I must say, I'm not sure the person I spoke to was 100% sure of their knowledge anyway. This is why I asked about the anti-d as I know it's to prevent rather than get rid of antibodies. So hopefully they just made a mistake and should have said baby MAY be +ve Anyway, midwife wanted me to get checked again with antibody screening and blood was sent off yesterday and HOPING for results today or Monday - I'm just impatient and need to understand it all

Thanks a lot for your time

Remember that your blood is most likely to test positive for antibody now because it will pick up the prophylactic anti-D you were given. It all gets a bit confusing.

Oh......shouldn't my midwife have known that then (you mean i had even more blood taken for nothing? ). So this test won't know whether it's normal antibodies or anti-d then??? How will i know whether or not I was caught in time? (other reason for concern is this fall was TINY and i didn't land on bump or anything so I'm not 100% sure it's the fall that caused the mix and therefore whether I got it within 10 days?)

It may be that they will want to monitor the anti-D level and see if it rises. It will be present because of the injection so you will need another test perhaps in a month to see if it has risen.

How pregnant are you?

Don't worry too much about antibodies - I developed antibodies in my second pregnancy - baby was fine. The effect is greater in subsequent pregnancies.

Thanks for the reassurance. I'm 13+4 today, was 12+1 the day I fell. 2nd pregnancy and showed NIL antibodies from booking bloods at about 8 weeks. Did you say because dh is A+ then I'll probably have a +ve baby? So is ds likely to be +ve too? Questions, questions I'm a bit of a control freak with medical stuff due to things going wrong with my sister so I like to do my own research!

Well although the full blood count results were in this morning, the screening test isn't back so have been told to try again on Monday between 2-3pm. But from what you said, this test is pretty pointless now?!

I am really surprised that you had a positive kleihauer test at 12+1 weeks. Anti-D is not necessary before 12 weeks even when there has been bleeding, unless there has been a surgical intervention such as a D&C post miscarriage. It is such a minute amount of blood.

I wonder if the test actually did show positive. The assumption might be that anti-D is needed purely because you are rhesus negative rather than the test actually being positive IYSWIM? Women who have positive blood group babies identified post delivery get anti-D whether there is any fetal haemoglobin seen on kleihauer testing or not. The lab just says anti-D required. I suspect that this is what may have happened.

Did you get anti-D after delivery last time?

Even though your DH is A+, he could father either a -ve or +ve baby depending whether he is homozygous or heterozygous positive. Homo means the father is ++ and can only father positive babies (my DH is this). Hetero means +- so baby could be positive or negative. My DH was tested because of me developing antibodies.

Your story is really interesting me as you can tell. Ask your midwife what the exact kelihauer result was.

Mears - this is why I started questioning everything in the first place, as I was very surprised that I had a fall 1 day over the 12 week mark that they talk about and it showed this result. I'm very confused. I had the blood test at 12+4 (fell at 12+1) and the hospital phoned me and said I'd definitely shown my baby's blood had mixed with mine, even the Dr who came to see me from the Gyno ward said the same They said on the phone it was urgent for me to come to the hospital - I nearly had to cancel a hotel that I had booked for a night out and they knew this but insisted and of course I wasn't going to risk anything.

I wish I knew if ds was -ve or +ve, all I know is I don't remember having an anti-d after his birth so maybe they tested his cord blood without me knowing and there was no need? I did have anti-d's after 2 other pregnancies which ended before 12 weeks just as standard procedure.

I phoned the midwife this week to ask some questions as I'd been called to the hospital and she didn't know, she knew I had now had anti-d and she arranged for this screening which seems pointless now after what you said???

I will ask my midwife about the test, she didn't know when I called as the result wasn't on the computer at the time and when I called the hospital back to get the exact results, the midwife on the phone there was snappy and said the results were no longer there....bye bye type thing!

This reads more to me that you possibly do have antibodies showing in your last test, rather than a positive kleihauer.

Sometimes anti-D is given to 'mop up' any other fetal cells that may be around to prevent further antibody formation.

Please do not worry about this at the moment because it may be totally wrong.

I would phone and ask for initial results. Ask if antibodies were detected (in which case baby would be positive and that is how they know). You have evry right to know.

The results will still be available on compuer by the way. In my area the GP can access them so you could try them if you don't get an answer from the hospital.

Who can I phone? Dr's or midwife (midwife's mobile number is on notes but I never know when I can/can't phone)

Community midwife usually works till 5pm. I would call her today and ask her to phone you back - purely to update me if nothing else

Ok, so if I call Dr's surgery now I should be able to find out from the receptionist?

hi, sorry to jump on thread, but was reading with interest as i know a small amount about re- and anti -d ( a newly qaulified m/w mears has far more valuable experience than i do so love to read what she has to say)

anyway just wanted to say, at the hopsitla i work at, they take cord blood form babeis with rhesus neg mums and test that, then also take a venus blood sample from mum to compare. this is how they know if babys is + or -

hth a bit.

hehe, so I'll phone her mobile then

Don't worry if you cannot get anyone today - it will not change anything at all about what needs to be done between now and Monday. If you have tested positive for antibody formation, you will be closely monitored for any increase throughout your pregnancy.

lubyluby is right - cord blood is tested for all negative women and blood is also takenfrom the mum after delivery to check kleihauer and antibodies. Cord blood tells you what baby's blood group is.

Will pop back later for an update