Please or to access all these features

Add post

Watch this thread

Save thread

Start a new thread

Flip thread

Hide thread

My feed

Active Unanswered threads

Getting started FAQ's

Unanswered threads Acronyms Talk guidelines

Hide shortcut buttons

Talk

Pregnancy

Talk about every stage of pregnancy, from early symptoms to preparing for birth.

Flip

1 2 3

Original poster

Anti-D question

60 replies

Cosmogirl · 09/01/2009 16:12

Hi ladies,

Wondered if any RH negative ladies can answer a quick questions. I just had my anti-D jab today at 28 weeks (first baby). Had to go to hosp where I am due to give birth as community midwife in our area don't do it. The lady who did it said that I would only need the one jab (unless I have a bleed). However, I was under the idea you have two - one at 28 one at 34 - even says this in my notes.

Is she giving the correct info?

TIA.

Ps. Was very pleased as it didn't hurt like I thought it would. She did it in a fleshy bit of my thigh. Arm where she took the blood hurts like hell though! Feels really stiff and achey.

OP posts:

Are your children’s vaccines up to date?

Set a reminder

electra · 10/01/2009 13:06

Yes, I would always have the anti-d after delivery - which I have before. Actually, after dd2 I didn't think I would have any more children so nearly didn't have it, but you just never know and now I'm expecting dc3.

ilovetochat · 10/01/2009 13:10

i am rh -ve and when pregnant dp was tested at hospital as rh -ve so i didn't have the anti-d injections. they tested me for anti-bodies and there were none. At 9 weeks i had a bleed, at 12 weeks i was in a car crash. when dd was born se was rh +ve. they came and told me when dp had gone home presuming he wasn't the dad. he is dds dad. so he was retested at the hospital dd was born at. his test came back rh -ve with a small rh+ve and he was told he was very rare and they wanted him to give blood.
so dd was def rh +ve (although they did admit they didn't label her sample straight away so there was a margin of error).
i had the anti-d injection just before i left hospital. i had dd 2am wed morn and had injection 3pm fri.
i am now scared of complications if we have another child.
obviously i would have all the injections this time.
anyone?

electra · 10/01/2009 13:15

If you were going to try for another baby - you could ask to have a blood test first to see if you have any antibodies. A midwife told me that antibodies can sometimes be the reason for early miscarriages if there are any. But I think they now take blood very early in pregnancy - I had mine done at 8 weeks. So if anything showed up at that point you could get it treated quite early.

tristaleejac · 10/01/2009 13:16

My notes say 28 and 34 weeks but MW scored out 34 week part saying that they don't give 2 anymore. Seems to be different wherever you go? I was also given a wee laminated card to keep in my purse which says if I have any falls or injuries to tummy I must go straight away for anti-D. Anyone else had this?

electra · 10/01/2009 13:19

Yes, I have the card. Actually I was kicked in the tummy at 17 weeks and I went to see my doctor. He said that he did not think it constituted a sensitising event because I had no bleeding. He said there would have to be considerable force for me to require an injection.

tristaleejac · 10/01/2009 13:20

You were kicked in the tummy I hope by a toddler and not someone who should know better!

HeathersMummy · 10/01/2009 21:05

I'm RH neg and DH is RH positive and I've just given birth to DC2 who is RH pos (DC1 also RH pos). Anti-D is not offered during pregnancy in my area so is not an option, however I would not hesitate to recommend it to anyone who is in 2 minds about the whole thing.
During my pregnancy it was identified that I had anti-C and anti-D antibodies in my blood, so I had routine blood checks every 2 weeks to ensure that the levels did not rise. They stayed very low, so I had put all concerns for my baby out of my mind.
When DC2 was born and his cord blood checked, it was identified that he was Coombes positive as a result of the antibodies in my blood. He had a pretty severe case of jaundice and only marginally avoided a blood transfusion. The antibodies in my blood have launched an attack on his red blood cells and we were kept in hospital for a few days after he was born. His jaundice was treated with phototherapy and he continues to take folic acid daily (which he will do for 4 months), we attend hospital every fortnight to have his jaundice level checked and a full blood count carried out (he is in danger of becoming anaemic).
I've been told that there will be no lasting health concerns as the jaundice is now under control and the levels are coming down however it will take a full 4 months to come out of his system.
I would give anything to have been able to get the Anti-D injections, I'd rather have had a couple of them than have to continue watching paediatricians draw blood from my 3 week old baby
Please think carefully about the choices you make about Anti-D...I had minimal antibodies in my blood, but my son has still been very poorly.

electra · 10/01/2009 21:27

Heathersmummy - I think it is bad that they had identified antibodies but did not give you any treatment.

thumbwitch · 11/01/2009 00:55

electra - it is highly complex and I'm not sure I can remember it all perfectly - I used to work in the Blood Transfusion Service several years ago so here goes:
antibodies can have various levels - they can be low in level but high avidity - this means that even though your level is low, they are pretty dangerous. You can also have a high level of antibody that are low avidity - this reduces the risk. High level, high avidity is obviously very risky and can involve intrauterine transfusion. (The earliest I know about this being performed was at about 14 weeks gestation - the Rh antigens are not formed on the foetal blood cells until 12 weeks.) So, level alone is not always a good indicator. The levels can rise quite fast and if you are just having routine blood tests it might not be picked up - i.e. at one test you might have no antibodies and then at the next have a really high level.

There is no routine prophylaxis available for anti-C and it would have been pointless anyway in Heathersmummy's case as she was already producing anti-C. Anti-C is just as capable of causing a blood reaction as anti-D, although far less common, so her son's condition might have been caused by either antibody, or by both. Heathersmummy - anti-D prophylaxis in your particular case probably would have made no difference.

This is in the guidelines on the administration of anti-D in the UK, updated June 2008.

SECTION 3:MANAGEMENT OF A ROUTINE PROPHYLAXIS SCHEME. 3.1 Administration of routine antenatal anti-D prophylaxis (RAADP)This section takes account of the publication of the NICE guidance which recommends that RAADP is offered to all D negative non-sensitised pregnant women at 28 and 34 weeks gestationat routine antenatal visits (NICE, 2002). A dose of at least 500 iu, i.m. is recommended on each occasion.

A single dose of 1500 iu anti-D, given i.m. at 28 weeks, may be an effective alternative RAADP regimen that potentially offers cost and logistic benefits. However more evidence is required to establish its comparative efficacy. Use of routine antenatal anti-D prophylaxis should not be affected by previous anti-D prophylaxis for a sensitising event early in the same pregnancy. Likewise postpartum anti-D prophylaxis should not be affected by previous routine antenatal anti-D prophylaxis or by antenatal anti-D given for a sensitising event.

SheWillBeLoved · 11/01/2009 11:56

Didn't wanna start a new thread with the question I have, so if anyone has any info that'd be great -

I had a mmc in August 06, had medical management, and then had a shot of anti-D before going home.

I had a bleed at 6 weeks in this pregnancy. This morning I got a letter with results of my blood test, telling me i'll need anti-D at 28-30 weeks and after the birth. In the leaflet though - it says that anti-D should be given if you have had any vaginal bleeding, which I did at 6 weeks. I asked EPU at the time and they said I don't need it until after 11 weeks, and the midwife at my 12 week scan didn't bat an eyelid when I told her I was Rhesus D- and that I had bled earlier on.

I'm 13+3 now.. will/should everything be okay? Or should I get in touch with my community midwife tomorrow and ask her opinion?

Lotster · 11/01/2009 12:04

Hi there, I had anti-d at 28 weeks and after the birth (2004) with my first pregnancy.

I'm 32 weeks PG with 2nd and just had anti-d a 28 weeks and again, told will have it after the birth. Am in London.

27 · 11/01/2009 12:06

Shewillbeloved

Im rh- and also had an early bleed, and was told the same as you, that I didnt need anti-D that early on.

SheWillBeLoved · 11/01/2009 12:10

27 - thanks for replying

It's just with them saying it's not needed until after 11 weeks.. and now i'm 13 and abit worried about whether they meant i'd need to arrange it for after 11 weeks or I just wait until 28-30 weeks like everyone else..

Forgot all about it really until getting that letter this morning

Lotster · 11/01/2009 12:12

Ireguina - I just noticed your post linking mercury and autism. Having had a severely autistic cousin this is alarming to me that he should be significant for them to record in my notes but no-one told me any links between anti-d and autism. do you know any statistics?

I didn't really get why I had anti-d after birth and then was told my son was a rh- anyway. Can I make them wait until they know my baby's blood type before accepting the 2nd anti-d shot do you/anyone else know?

27 · 11/01/2009 12:12

When I asked about it they said that it wasnt needed at all for a bleed that early (I was about 10 weeks I think).

I just had it at 28 and 34 weeks like eberyone else.

27 · 11/01/2009 12:14

Also, IIRC if anti D is needed it has to be given in 2-3 days of the bleed.

Boobz · 11/01/2009 18:25

How soon after the birth are you given the antiD injection (assuming mother is Rh-ve and baby is Rh+ve)?

I am planning a homebirth and was wondering whether the MW who attends will give me the injection straight after giving birth, or whether it's done at the hospital 2 or 3 days later (or even later than that?)

I know I can ask my midwife but not seeing here for another couple of weeks...

SheWillBeLoved · 11/01/2009 18:27

Boobz - in the leaflet I got yesterday from the hospital, it says that after giving birth it should be given within 2-3 days.

Boobz · 11/01/2009 18:36

cool thanks!

pooka · 11/01/2009 19:24

Bboz - when I had ds I had him on a friday night and was given the anti=d on sunday morning (at home)

Sunflower100 · 11/01/2009 20:53

Does anyone know whether it still contains mercury derivatives?
Also do you need it if your first baby is Rh -ve?

27 · 11/01/2009 21:01

You dont need it if your baby is rh-, but you dont know that until the baby is born, so you have to make a decidon about whether or not to take it in pregnancy without knowing if you need it or not.

In the hospital I had my babies in they test the cord blood before they give anti-D, so you only get anti-D after the babies are born if the baby is rh+

Lotster · 11/01/2009 21:33

sunflower - yes even if your first was negative they still give it to you in subsequent pregnancies. I did try to avoid it by saying this was my last pregnancy but they insisted I still needed it.

27 · 11/01/2009 21:40

Lotster - Its up to you whether you consent to treatment or not, they cant make you take Anti D.

Lotster · 11/01/2009 21:50

Well yes, I know they can't make me do anything at all, but if someone who knows far more than you about it is telling you that you really need it, it's a difficult situation to be in.

I didn't feel I had a reason to say no, but now I hear about mercury as a preservative I'm going to ask them about it and insist I get the baby's blood type results before a possibly uneccessary 2nd injection.
Was too battered after my first birth to even notice when they gave it to be TBH, will check at my appt next week how long they wait before giving it at this hospital.

Flip

1 2 3