Anti-e antibodies and pregnancy

[beckyphry]

Hi everyone. I'm looking for other mamas who have experience with anti-e antibodies during pregnancy.

I'm newly pregnant with #2. After the birth of my first child (emergency c-birth), my blood work showed that I had developed anti-e antibodies (basically, my husband has e proteins in his blood and I do not. My daughter must have the e protein as well, and during the surgery my blood was exposed to hers and my blood developed the antibody. This is just my own theory, I didn't get much info from my midwife after the birth).

I've been able to find very little information on the internet about this. It appears to be very rare (my midwife said she'd never seen it before), but it also seems to not be a huge concern in terms of risk to the baby. There is a 50% chance this bean could have the e protein in his/her blood, and if so, there's a small chance that there could be problems (there is a risk of anemia if our blood mixes, and my antibodies could attack the baby's red blood cells).

My first prenatal appointment with a new midwife practice is in a few weeks (I changed practices due to distance - also, my old midwife told me I'd have to see a perinatologist for any future pregnancies, so I know she won't see me again). The only information on this issue I can really seem to find is either technical medical journals that are impossible to decipher, or message boards, and the info on those message boards indicates a lot of medical interventions, including frequent ultrasounds, amniocentesis, in utero blood transfusions, early inductions, c-sections, etc. Not quite what I was hoping for this time around!

I'm hoping to find other mamas who have some experience with this antibody issue, and maybe some encouraging stories and/or advice about the course of treatment during the pregnancy. I'm hoping to avoid a lot of medical intervention and am afraid that lack of knowledge about this issue on the part of my new midwife's practice will lead to more interventions. Thanks in advance!

[Cativari]

I don't have anti-e but I do have anti -c. I'm not sure about the specifics on anti-e (I think I recall reading it's not a very active antibody, but can't be sure) but the presents of the antibody does not automaticly make one high risk or risk out of homebirth (if you choose to in the future). I'm seeing a family doctor now but I had planned a homebirth with midwife before dh got laid off. The protcal for both are to check titers during the pregnancy. Once in the first tri, monthly in the second tri and every 2 weeks in the 3rd tri, this is assuming that they aren't rising. If the titers do rise the doctor will want to do extra testing. (Rising titers does not always mean the baby is being affected.) Usually this will be extra u/s monitoring to make sure babe isn't showing signs of prenatal anmeia. If babe looks okay they'll prolly continue to watch for it. If there are signs that baby is badly anmeic the options are early delivery or if it's too early they might recommond an interuterine blood transfusion for baby. If the pregnancy is normal (no signs of anything out of the ordinary) you'll deliver as normal. After the birth baby will recieve the Kombs (SP) test if positive baby will be observed for janduice. They can test cord blood so ask about that in leu of poking babe. If negitive you're in the clear.

The best advice I have is to find a doctor/midwife that is not intervention happy. This antibody can be monitored without much interferance (the extra blood tests and maybe an extra u/s or two) if you have an informed doc. Be honest with your HCP when you're getting uncomfortable with the direction your care is taking and do your research on any and all things they want to do with you. (((HUGS)))

ETA: I'm not a hcp always seek medical advice before you decide anything.

[craftmuffin]

I'm not in your exact boat either, but I just found out I have anti-C antibodies. Being rh-negative, when I got the call about antibodies in my blood I just assumed it would be anti-D. I've been second-guessing all of my previous RhoGAM decisions and worrying for weeks until this morning's appointment with a specialist. Turns out RhoGAM (or lack thereof) had nothing to do with it!

The way this doctor described it, different antibodies have different probabilities of causing problems for the baby, but in all cases these effects are usually mildest if it's the first affected pregnancy. My titers* are low right now, so the plan is to retest each month and hope that it stays low. If they reach a certain point (1:16 or higher) then special ultrasounds may come into play.

Very low chance of any further interventions in my case (huge relief!), but I am nervous about possibly being advised to induce early. And I'm sad to think that extra time in the hospital may be needed after the birth if billi treatments or anything like that become necessary. But I guess we'll cross those bridges if we come to them.

I hope you get more info and will give us an update soon!

*Titers were explained to me as a dilution process. If your blood tests positive for the presence of an antibody (1:1 titer), then they dilute your blood 50/50 with saline or whatever and test again. If it's still present (1:2 titer), then they dilute and test again (1:4) and again (1:8)... until the antibody can no longer be detected. Just fyi since I had no idea what it meant!

[poppybarella]

Hi my name is poppy and I'm onto my 5Th pregnancy with anti E antibodies and with the last 2 pregnancy's i had complications, but the doctor told me because it was a Chang of sex as they were boys. Apparently I'm not to bad with girls but still got checked with bloods, every month until they were high and give birth early but the girls were OK and healthy.

When i was carrying the boys it was a different story they were both born with the same anti bodies but the pregnancy was different with scans every week for development and the blood tests went from every month to every week until they were dangerously high and got to deliver my first son at 34 weeks and he had cord blood taken and he was yellow so he had full blood transfusion and was put under the ultra violet light for 2 weeks and he weighed 4lb and lost another 1lb because he was poorly, but he pulled through and came out of care and was able to take him home and now he is 7 today he is doing really well.

My other son was the same but born at 30 weeks and was 3lb and there was nothing on him but same again he pulled through and he is doing relay well and he is now 2 years old, and the girls were OK at birth but has developed type 1 diabetes because of the antibodies cant fight the infection they had but they cope relay well and they are 10 years and 9 years old, and I'm doing it all over again but this time we don't know the sex of the baby, but we will cope considering i have anti bodies.

My self and my partner both have the anti E antibodies witch neither of us knew until i was 24 weeks with the first baby but it was a shock and we asked questions and went onto the Internet to find more information witch was good and some bad information, just be careful on what you read in the net as my consultant said don't always believe what you read on these things because they are not always right.

Doctor told me as well, once you have anti E antibodies you will always have it and wont go away so every baby you have it will have anti bodies and be a carrier of the anti E so when they have children they get checked and so will there partner. I'm also a carrier of cystic fibrosis lucky my partner is not otherwise we would have a child with it.

Hope this is helpful, and to let you know you are not on your own. Any time you need to talk just send a message, i feel I'm an expert now lol xxx

[MELISSA333]

hi! am am 23 weeeks along with baby #4 and i tested positive with the antibody E with my 3rd.

that pregnancy was uneventual and my levels never rose higher than 1:4.

this pregnancy,my levels seem to be doubling rapidly and i actually recieved word today that the levels are up again,so i am being refered to a specialist tommorow for more testing.

from what i understand,this is a pretty rare antibody and generally,everything turns out well.

however there are possibilities that the baby could be anemic and juandice at birth,in worse cases,the baby will need transfusions in utero and may need to be delivered early. worst possible case scenario is that the baby is still born,due to mothers antibodies attacking baby's blood.

from what ive heard as long as ratios are 1:16 or lower there is no need for major concern or extra monitering. as mentioned,most cases with antigen E turn out fine.

hang in there and do keep us posted with how things go!

MC

[jdtmommy]

I also have the E antibody but was not effected by it in till my 3rd child. From what my doctor has told me and personal experience it is very serious. I hemorrhaged with my first delivery and received a blood transfusion in which i got the antibody. I was told it skips the first child and gets worse therefore after. I was tested for antibodies while i was pregnant but nothing showed up. When i delivered my 3 son he was immediately rushed to the nicu and almost died. He was there over a month and had to have a complete blood transplant. followed by multiple blood transfusions and 3 times a week blood test in tell he was 6 months when he outgrown it. I have been told that it is very unsafe to have more children and that if i ever decide to i would have to see a high-risk obgyn weekly in till i deliver and it is more likely that i will miss carry late term or have a still birth due to the swelling in the baby's organs while pregnant. I suggest you see a specialist and be very care full the E antibody is very serious. Hope this info helps!