Anyone had an RH sensitized pregnancy?

[momtoafireteam]

When my DD3 was born I had had a horrific delivery, she was in the NICU and I was on mega drugs and I turned down the Rhogam because I KNEW I never evereverever wanted another baby.

Now, here I am. 6 weeks pregnant. Now what? I had DD3 tested and she is B+ so this is now something I have to be concerned about. I have my first OB appt next week.....

If you had a pregnancy while sensitized, can you tell me about it? What were the effects for you and your babe? Any advice you can all give me would be wonderful, I am kind of freaking out here.
Thanks girls!

[Xiaohua]

So sorry about your daughter's birth! I am rh- and have done a lot of research on the topic, but have not been sensitized, so I have no personal experience. However, please dont ASSUME that you are sensitized. It's true that your birth experience might make it more likely that you were sensitized, but even in the absence of rhogham the sensitization rate is still pretty low. I'd take a deep breath and ask your OB to test your antibody level's now. There is a chance you are NOT sensitized and have nothing to worry about. Well, in that area, anyway...

If you are sensitized you'll want to know as early as possible because they can monitor your baby during the pregnancy. You'll probably be followed by some specialists, particularly as you get nearer to term. They might decide it's safer to delivery early and balance the problems of prematurity with the problems of having baby stay in your body where your antibodies are attacking her blood. They might need to give baby a blood transfusion, and I have even heard of doing that prenatally, but I don't know if it's common.

With advanced medicine these babies have a much better chance, but again, prevention is a lot easier and I don't think you see many babies suffering from rh disease these days; it is pretty rare.

I had a mc earlier this year and knowingly declined the rhogam. I am pg now, and the first OB I saw flipped out and told me that was stupid, made a big deal of checking my antibody levels right away. They were neg (not sensitized) , but I had not been worried. I had done my research and was comfortable with my decision. The next time I saw a different OB and he seemed rather blasé about the whole thing and said for miscarriages earlier than 12 weeks he doesn't even recommend it. Guess it all depends...

Anyway, I hope you can get an appt and get some bloodwork done. Either way, you can put that worry behind you or start planning what you'll need to do to carry this next little one as safely as possible.

Please update and let us know what you find out. You'll be in my thoughts.


Serena

[sanguine_speed]

I was in a very simliar situation. My third birth was very difficult physically (pre-term vaginal breech that got 'stuck' and had to be very forcibly removed), and I also refused Rhogam for a similar reason. At 16 weeks with this, my fourth pregnancy, I tested positive for antibodies. As it turned out, my positive screen was false, and caused by the Rhogam I did take at 6 weeks pregnant due to heavy bleeding (SCH).
During that time that I was unsure whether the results were valid, I did a lot of research about RH-sensitization and did find the rate is low, even with Rhogam, and that while the potential risks are very serious, there is still a very good possibility of a good outcome with a sensitized mom and rh+ baby. I know the mourning though, of a non-normal pregnancy and possibly birth, so I feel for you.
Why not get tested for antibodies?

[momtoafireteam]

Originally Posted by sanguine_speed

Why not get tested for antibodies?

Oh, I definitely will ASAP. My first appt is on wednesday and it will be the first thing I do, hopefully the results will be good and I can stop worrying about this. Thanks for your responses!

[japonica]

I have had two successful sensitized pregnancies. My winrho failed.

Yes, first you'll need to be tested to see if you even are sensitized. A titre (amount of antibodies) of 1:1 will mean possible sensitization but the tests also manage to pick up residual antibodies from the rhogam shots (false positive). This happened to me and the OB and peris thought it was just my residual winrho until my titre started to rise...that indicates true sensitization.

My first sensitized pg was pretty uneventful. Regular blood draws to monitor antibody levels. Most OB won't even send you to a peri until your titre hits 1:8 or 1:16 (it goes up incrementally...1:1, 1:2, 1:4, 1:8 and so on). Mine hit 1:8 by the third tri of my first pg and I was sent to the peri at 30w for additional monitoring...basically doppler ultrasounds to check the baby for anemia and BPPs (bio physical profiles). She did very well and stayed in until 37w when we induced...she ended up with pathological jaundice and spent 6 days under the bili lights, but no post natal transfusions or complications and was fine.

My second iso pg went really well, even though my titers were 1:32 at the start and went to 1:64...we started the MCA dopplers at 19w and continued every 2 weeks through the pg. He stayed in until 37w and was also induced and spent a week under the bilis. No complications or transfusions.

I was fortunate with both kids that I didn't have to undergo any intrauterine transfusions (which some moms have to do). But peris are skilled at the procedure and chances are with a first iso pg that you wouldn't need it.

Good luck. If your test comes back positive, get in touch. I know of an online BG (another forum) specifically for iso (isoimmunized) moms.

[Belle]

Originally Posted by momtoafireteam

Oh, I definitely will ASAP. My first appt is on wednesday and it will be the first thing I do, hopefully the results will be good and I can stop worrying about this. Thanks for your responses!

Also, keep in mind that even if you are sensitized 40% of babies born to Rh- moms are negative themselves. There is a posibility that the baby you are pregnant with is negative too.

[japonica]

Originally Posted by Belle

Also, keep in mind that even if you are sensitized 40% of babies born to Rh- moms are negative themselves. There is a posibility that the baby you are pregnant with is negative too.

Thanks Belle...I forgot to add that...

If you test positive for antibodies, they will ask your husband for a blood test as well to check his genetic status re: that antigen. Even though your husband is Rh positive, he might have a negative gene for that antigen...they usually express it in terms of "homozygous for D" (for example) or "heterozygous"...homozygous means ++ and no chance that you would have a baby who is negative for that antigen. Heterozygous means +-, or carrying a negative gene for that antigen, so a 50% chance that the baby would be negative for D...hope that makes sense...moms with a heterozygous husband sometimes elect for testing of the fetus around 19w then to see if the baby is Rh negative. If so, then they can skip all the ultrasounds and further monitoring because obviously the baby would not be affected by antibodies and it would be a "normal" pregnancy.

In my case, my husband was tested as soon as I got word that I was sensitized. He's homozygous for D, so we knew every baby we had would be affected by my antibodies.

[Belle]

Yes, what Japonica said. I am not sensitized but I know that my dh is heterozygous because our oldest was Rh-. If any of your previous children are Rh- your dh would not need to opt to be tested. You would know that he is heterozygous and your child has a 50/50 chance of being negative.