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RhoGAM? - Page 3

post #41 of 65
That is awesome!
post #42 of 65
Quote:
Originally Posted by mom-to-jj View Post
At what point after birth is a baby's blood tested? I'm wondering how I will know if I should decline the shot after the birth. I felt like after DS was born, the doctor and nurses told me nothing about what was happening either to him or to me. I have no idea at what point I was given the second Rhogam shot, and I have no idea what my son's blood type is.

Is it incumbent upon the mother to ask that the baby's blood type be compared to her own before the shot is administered? Why don't they just do that automatically?
i have my medical records from my son's birth and i believe they must've tested his blood right away, because i don't *think* i got the shot. (he's a negative blood type like me). i don't remember getting it and it's not in my records, but they might've given it to me. next time i'll definitely ask beforehand how it will all work!
post #43 of 65
Blood is tested immediately with a sample from the umbilical cord. Some midwives test right there on the spot with an Eldon card. I don't trust them so I send mine to the lab.
post #44 of 65
so there is a test that can be done in pregnancy that determines Rh factor of your baby- it isn't an invasive test and so there is no risk of creating sentization by having the test done I found out about it from another midwife the company who will test a pregnant mom's serum to get info about baby's RhD status- it is approved in NY this would give you info about baby's blood so you could decide to get the Rh prentatal shot or not --- I haven't used this lab and don't know much more about it- I mentioned it before and maybe someone else on MDC has contacted this lab and had it done---

Lenetix® Medical Screening Laboratory, Inc.
174 Mineola Boulevard
Mineola, New York 11501

and here is a web page link-- http://www.lenetix.com/


so that could eliminate some of the concerns about safety for Rh- babies being exposed unnecessarily --
post #45 of 65
I am 26 weeks pregnant and Rh-, my husband is Rh+ and my midwife wrote me a script for the 28 week RhoGam shot. i am hesitant to get it and as of right now would like to pass but have Baby's blood tested at birth and if baby is Rh+ then i would get the shot.

i have been reading the threads on here so far but i have question that i haven't found answered yet.

what are the risks to BABY by not getting the shot at 28weeks?

thanks ladies!
post #46 of 65
There is a very minimal risk to this baby. Because it takes some time for you to build antibodies once sensitization occurs, the incidence of effects on the fetus during the same pregnancy as when you become sensitized are extremely rare. It is so rare that I've never seen reported statistics. That's not to say it's not possible, but much less likely than in subsequent pregnancies.
post #47 of 65
Oh, thank you for that link, mwherbs! I was just asking the backup OB about this test the other week, and he didn't know what I was talking about - said he thought it could only be done by amnio, and was generally not much help.

To the OP, I am having trouble deciding about this as well. I don't like the risk that the baby's blood might be attacked by the rhogam (so frustrating that there's no data!), and I don't like the risk of getting sensitized and having to deal with all the medical stuff in a future pregnancy. My midwife doesn't routinely do the prenatal shot, but I had a sensitization scare after my miscarriage (turns out the anti-D reading was just from lingering Rhogam, I'm negative for it now, yay!), and so I had a while to think about what it would be like to be sensitized, and I'm not really comfortable just skipping the shot. Plus, I had two shots while pregnant with DS (one routine, one after an external version, and I had to keep pestering them to bring it to me), and he was very healthy. So lately I've been leaning towards getting the shot.

Still, I really like the option of testing to find out if the baby is positive or not! I was upset when the backup OB wouldn't try it - I'll have to see about this website, I wonder if my midwife could just do the blood draw herself.

One more test that hasn't been mentioned on this thread is called the Kleihauer-Betke test, and it's been around long enough that most OBs should be able to do it. It tests to find out how much fetal blood is in your circulation. If they find a lot, it's possible that you might actually need more than the standard Rhogam dose - that might be why some people still get sensitized even when they get the shot. However, it isn't perfect. I've been looking into it as hard as I can, and there's a chance that it won't detect really small bleeds. It's still worth doing, I think, to make sure you aren't having a really big bleed, but if you get a negative result it isn't a 100% indication that you don't need Rhogam, you'd still be stuck with that decision.

It's very annoying, actually. Why don't they know everything by now?!? I want hard data!
post #48 of 65
post #49 of 65
There is another factor that no one has mentioned that I know of, and it is the ABO sensitization. Yes, it does factor in with your chances of becoming sensitized with the Anti-D. If the mother is type O and the baby is either A or B, there is sensitization there too that can cause a milder reaction. However, with that sensitivity, the type O woman is less likely to develop antibodies for the rh incompatibility. So, the 1.8% goes down even further for those women. I believe that is anther factor that should be considered when deciding to get the Rhogham or not.
post #50 of 65
reviving this thread a little
I was searching MDC for info in SCH and rhogam.
I am 6 weeks and they found a very small active bleed on ultrasound yesterday.
I am Rh- and DH is +
My doctor said she was not too concerned about the SCH but then next sentence asked if I had had my Rhogam shot yet.

I had the shot at 28 weeks when I was pregnant with my DD who is now 3

I was planning on waiting until this baby was blood typed to make a decision about Rhogam, but wondering what everyone's opinion is about having it at 6 weeks because they know I am bleeding.

FWIW I am asymptomatic for the SCH. I got the US to date the pregnancy, the SCH was kind of a surprise
post #51 of 65
Quote:
Originally Posted by ~Pony~ View Post
reviving this thread a little
I was planning on waiting until this baby was blood typed to make a decision about Rhogam, but wondering what everyone's opinion is about having it at 6 weeks because they know I am bleeding.
Pony, one of the main arguments against routine administration of RhoGam during pregnancy is that, in the absence of bleeding or abdominal trauma, the chance of sensitization occurring is very low, because the chance of maternal exposure to the fetal blood is very low. The argument is that, unless there's some reason to believe that maternal and fetal blood are mixing, the shot isn't actually necessary.

This doesn't apply to you right now - you're bleeding. The odds that you are being exposed to fetal blood is high, and there's at least a 50% chance of Rh factor incompatibility. When I was in your shoes (with bleeding from a miscarriage at 10 weeks, and later with bleeding from placenta previa in the late 2nd trimester), I felt that getting Rhogam was the right thing to do.
post #52 of 65
Thanks for the quick reply, that is what I was thinking.
I just was not sure, with it being so early in this PG, if the baby even had a bloodtype yet.
But I suppose if the SCH continues to bleed I will eventually have to get the Rhogam shot anyway though, right.

My Dr. really did not seem concerned about the SCH but it just spooked me a bit that she wanted me to run in and get the Rhogam.
Thanks again
post #53 of 65
Before 12 weeks, the mini-dose (120 mcg) is appropriate. You might ask the doctor about that. The thing to remember is that even though you are only 6 weeks and the bleed is very small, the Rhogam will circulate in your system for 12 weeks, so getting it now is the very best thing you can do to prevent sensitization if the bleed continues or gets worse. If you wait it could be too late, whereas if you do it now it continue to protect you.
post #54 of 65
EmmaWoodhouse-- where can I find more info regarding the ABO incompatibility affecting the likelihood of getting sensitized? I am O- and really don't want to get the shot even though my dr. wants to give it to me at 26 weeks, I am trying to find as much info as I can to try to get her to discuss it with me logically and not just get pissed off which she did when I brought it up at our first visit.
thanks
post #55 of 65
To the OP: Looks like you are getting a lot of info, possibly still some conflicting and confusing info. So i thought you might want some ideas about what other mamas have done.

I am Rh-neg. With baby#1, I was "mainstream" and ended up with an unnecessarian. I took the shot at 28w and again after surgery.

With baby #2 (after reading lots) I chose NOT to get the 28w shot, and then after the baby's blood type was tested, I DID have to get the shot after giving birth at home.

I wanted to leave my options open for future pregnancies.
post #56 of 65
Quote:
One more test that hasn't been mentioned on this thread is called the Kleihauer-Betke test, and it's been around long enough that most OBs should be able to do it. It tests to find out how much fetal blood is in your circulation. If they find a lot, it's possible that you might actually need more than the standard Rhogam dose - that might be why some people still get sensitized even when they get the shot. However, it isn't perfect. I've been looking into it as hard as I can, and there's a chance that it won't detect really small bleeds. It's still worth doing, I think, to make sure you aren't having a really big bleed, but if you get a negative result it isn't a 100% indication that you don't need Rhogam, you'd still be stuck with that decision.
I had this done and it came back positive but we didn't find out until weeks after delivery. So, yes, it's a good indication that something is going on, but you need competent medical staff as well to make sure you get that larger dose of rhogam within the 72 hour window or I guess that's it. Well, that was our experience.

Quote:
There is another factor that no one has mentioned that I know of, and it is the ABO sensitization. Yes, it does factor in with your chances of becoming sensitized with the Anti-D. If the mother is type O and the baby is either A or B, there is sensitization there too that can cause a milder reaction. However, with that sensitivity, the type O woman is less likely to develop antibodies for the rh incompatibility. So, the 1.8% goes down even further for those women. I believe that is anther factor that should be considered when deciding to get the Rhogham or not.
Interesting, Emma. Do you have links for that? Just curious because I'm O- and with my first sensitized pregnancy, she was O+ and my anti-D titers rose throughout the pg. With my second sensitized pregnancy, he was B+ and my titers, even though they were higher, flatlined and stayed constant through the pg. And yeah, I tested positive for B antibodies after his birth. I've never heard of this before, but it's fascinating to think about.
post #57 of 65
Japonica- I have been trying to find info on how ABO and RH incompatibility can work to offset each other since I am also O-. I found a few research articles online from the 60s and 70s and if I have understood what I read the A or B or AB blood type entering your bloodstream will be killed by your blood too quickly for you to form antibodies against the RH- part of the blood, it will just be destroyed, so you will not form the antibodies.

While doing the figuring, on a very basic assumption that with my husband who is A+ (but whose father is A-) and my O- (with an A+ mom so I assume I carry that) my babies have a 3/4 chance of being A type in which case if any A type blood enters my bloodstream it will be killed by my blood whether or not it is RH+ or RH-. The baby will also have a 1/2 chance of being RH - since DH and I each carry the + and the -. I haven't looked into whether it's those simple of percentages.

The only way that this theory would not work is if the baby carries O+ because my blood would not kill off the O but only create antibodies to the RH+. This is totally my theory based on what I read and I really have no idea yet just what the likelihood actually is of the baby inheriting either the A or O type, or the +/-, as that was just too much for me to look into, but I do feel satisfied with my numbers and it eases my mind for now

I have the title of one of the articles I read:
the inhibiting effect of ABO incompatibility on RH immunization
but I'm not sure if that one talked about the right thing, but they were all on the same website if you wanted to search it.
post #58 of 65
Just a small note, Is it puppies? - if you're O neg, you can't carry A genes or rh-positive genes. Both of those traits are recessive, meaning that you have two O genes and two rh-negative genes, nothing else. You're right that your husband must have one positive and one negative gene, and your kids still have a 50/50 chance of being rh-neg.

As for the A gene, unless you know your husband's parents' blood types, he could be either AA or AO. If he's AA, then all your children will be A. If he carries the O gene (AO), then they once again have a 50/50 chance of being A or O. So I guess if you put them both together you could call that a 3/4 chance, if you put them both together.

Sorry if you already knew all that, but I always loved doing Punnet squares in biology and figured I'd go through it if you were interested.
post #59 of 65
This is the part that I actually haven't looked into yet, after trying to decipher the articles I fried my brains and they still haven't recovered enough to try to understand that stuff
so if I get you-- I can only carry O and Neg even if my mom was A + ? I wasn't sure about that. But it seems like it would sort of make sense after some of the things I read but haven't really deciphered yet
My DH's mom is A+ and his dad is A- so can I assume he is AA+- (not sure if I put that correctly but I think you get it)?
So my figuring, though not quite right, still mostly works out if the theory is at all correct

I also remembered after my last post, that in the ABO incompatibility the A is the "least" incompatible with the O, so that there would be little likelihood of any problems occurring and that the way I do my science the baby is most likely to be A+ or A- and very unlikely to suffer from RH incompatibility and only mild jaundice if at all being A. I think that B and AB had the potential for a more severe reaction from ABO inc.
post #60 of 65
http://www.moondragon.org/lab/abod.html

not that this site looks very scientific, but it does sort of explain stuff. The other thing that I was planning to look into is the Duffy factor (?) which I think means that the blood is practically positive anyways- but I don't really understand how that works.
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