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#61 of 116 Old 01-05-2007, 09:03 AM
 
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Geesh, you see what I mean? I don't even know what to look for! I *assumed* it was true that RhoGam was the IgM. Therefore everything I searched was assuming the same. Now, I read back through my links and see that they all say something along the lines of "Most antibodies against A and B antigens are of the IgM type" *MOST* being the operative word, and clearly, RhoGam is not, according to your link. It makes me mad, b/c the first 2 links *clearly* make it sound as though RhoGam is IgM. The lies make me angry.:

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#62 of 116 Old 01-05-2007, 01:25 PM
 
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Peppermint, the way it was explained to me is that it would be impossible to even find IgM antibodies for this purpose, because IgM antibodies are made for the short term - as soon as the exposure happens. They're made long enough to allow the body time to start manufacturing IgG. Since RhoGam is a blood product, made from women who have experienced Rh sensitization already, if they wanted the product to be IgM, they'd have to collect it immediately after sensitization occurred, so there would still actually be measurable IgM antibodies in there. Then they'd have to figure out a way to remove all the IgG that had already been created. It would not be feasible at all - how would they know exactly when a woman had been sensitized???
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#63 of 116 Old 01-05-2007, 02:57 PM
 
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i am researching to find out if my understanding was wrong. it might take me a few days to get back to you, but i'll post if i realize my understanding was flawed or if i think it was correct.
meanwhile i found some interesting articles.

this one deals with the number of silent FMH, which was discussed earlier in this thread:

http://www.thomsonhc.com/hcs/librari...d/31#secN67850

Quote removed as it exceeded the 100 words or less allowed by MDC's Copyright Policy
this article discusses when/how/quantity of anti-D to prevent sensitization:

http://www.ncbi.nlm.nih.gov/entrez/q...=pubmed_docsum

"Efficacy of prophylaxis relies also on the delay between the sensitizing event and the injection of anti-D, delay should be less than 72 hours. Intravenous administration of anti-D allows immediate neutralization of D positive fetal red blood cells and should be, if possible, preferred to intramuscular administration (IM). After a first injection of anti-D, if repetition of potential sensitizing events occurs, abstention of prophylaxis is possible depending on the previous administrated dose (protection lasts 6 weeks for 200microg and 9 weeks for 300microg) and the amount of feto-maternal hemorrhage. "

this article looked at 6 Rh studies to date (2000):

http://www.ncbi.nlm.nih.gov/entrez/q...=pubmed_docsum
Quote removed as it exceeded the 100 words or less allowed by MDC's Copyright Policy

finally, this one looked at failure of prophylaxis to occur:
http://www.ncbi.nlm.nih.gov/entrez/q...=pubmed_docsum



Rh immunization, despite universal Rh prophylaxis, developed in 25 women; eight before antenatal prophylaxis was administered, 17 after antenatal prophylaxis was administered. Residual Rh immunization is caused by small fetal transplacental hemorrhages (TPH) (greater than or equal to 0.01 mL of fetal blood) before antenatal prophylaxis (15%) and by significant fetal TPH (greater than or equal to 0.05 mL of fetal blood) between 30 and 38 weeks' gestation (18%); TPH was too great, in some instances, for residual passive Rh antibody to give protection.
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#64 of 116 Old 01-05-2007, 04:20 PM
 
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Originally Posted by iamleabee View Post
i am researching to find out if my understanding was wrong. it might take me a few days to get back to you, but i'll post if i realize my understanding was flawed or if i think it was correct.
meanwhile i found some interesting articles.
Thank you for the articles, I am off to read them, but in the meantime, wanted to see if you had read this link posted above:
Rhogam is IgG.
http://www.rxlist.com/cgi/generic2/rhogam.htm

It seems pretty non-disputable to me.

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#65 of 116 Old 01-05-2007, 05:38 PM
 
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Originally Posted by Peppermint View Post
Thank you for the articles, I am off to read them, but in the meantime, wanted to see if you had read this link posted above:
Rhogam is IgG.
http://www.rxlist.com/cgi/generic2/rhogam.htm

It seems pretty non-disputable to me.

Yes, iamleabee. I'm really not sure how you can dispute the description of the drug. What I think you should consider is who gave you the information you gave us, because henceforth, I would no longer trust that person or entity as a reliable source. Either they lie or they are grossly misinformed. Regardless, they're unreliable and you shouldn't trust anything else you learn from this source until you verify it independently. We can all see the information was incorrect without you verifying that fact for us.
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#66 of 116 Old 01-05-2007, 05:47 PM
 
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Clearly though, this is something that is being "taught" as truth to more than just iamleabee, I found lots of sources saying the same thing. The lies run deep and I wonder what the purpose is?

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#67 of 116 Old 01-05-2007, 05:48 PM
 
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Originally Posted by Peppermint View Post
Clearly though, this is something that is being "taught" as truth to more than just iamleabee, I found lots of sources saying the same thing. The lies run deep and I wonder what the purpose is?
What sources did you read that specifically said RhoGam was IgM?
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#68 of 116 Old 01-05-2007, 05:50 PM
 
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Originally Posted by Peppermint View Post
OK, here is what I find: (with a quick search)
http://www.madsci.org/posts/archives...8607.Me.r.html

http://www.path.sunysb.edu/coursemat...odlymphoid.htm

http://www.mfi.ku.dk/ppaulev/chapter32/kap32.htm

which all seem to agree with what I quoted, that the IgM *is* too big to cross the placenta. My issues are 2- I find MT to be very well-researched, and generally don't find her spouting things that aren't true, which leads me to the second part being, I don't know how to research this as well as I should, I suppose. All I can do is search google and see what comes up, I have found that I miss a lot when I try to look into things myself, and in the past others on this forum seem to be able to find the "other side" easier and help me see what I am missing.

I am simply a few weeks from having this injection again, and want to make the right choice. I am not having a "normal healthy pregnancy and intervention-free birth" so it really is more of an issue for me. One of the most convincing things I saw which made me re-think getting the shot, was the idea that it could hurt this baby, the one I am carrying *right now*, HE is my main concern, and I want to see him born healthy, and have a lot to consider with that.

This seems so different from all of the vaccines we discuss here, which, for me, have been easily proven not only harmful, but ineffective and unnecessary. I am feeling like this is not so cut and dry, at least for someone without a "healthy pregnancy and natural birth".
The first 2 links I posted in this post said it. Well, as I say, it was *implied* I suppose, with careful wording. They say "most" and then go on to presume RhoGam is IgM.

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#69 of 116 Old 01-05-2007, 05:54 PM
 
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I am just posting to say that my mother was rh- and never once had anti-D. She had 5 pregnacies and never had anti-D and had no problems. She has 3 negative babies and 2 positive ones, all in different orders. It is the boys that are + so I am not sure if that makes a difference but I think someone mentioned it may earlier. ( She had G,B,B,B,G in that order) I am RH- as well and refused it during pregnancy (although I may have had if if it turned out my ds was + although he was not). I just really don't understand the theory behind getting in it pregnancy. To me it didn't make sense which is why I refused.
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#70 of 116 Old 01-05-2007, 06:15 PM
 
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Originally Posted by Peppermint View Post
The first 2 links I posted in this post said it. Well, as I say, it was *implied* I suppose, with careful wording. They say "most" and then go on to presume RhoGam is IgM.
I didn't find them misleading at all, actually. The first link specifically says:
Quote:
Anti-Rh antibodies of the IgG subclass readily cross the placenta and can destroy the fetal red cells.
so I don't see how they're implying that anti-rh antibodies are IgM, since it says they're IgG. Since RhoGam is anti-rh antibodies, I don't see why they'd need to explain it in more detail. The only reason it discusses IgM antibodies is because the whole point of the page is to answer the question of why blood group antibodies don't kill the fetus. Since blood group antibodies are IgM, it's only appropriate to discuss IgM. In fact, IMO, it wouldn't even have been necessary to discuss the whole anti-rh antibodies, since that wasn't part of the question.

The second link only discusses administering RhoGam after birth, miscarriage or abortion. They never even mention administering it during pregnancy, so I don't really see why they would consider it relevant that RhoGam-derived IgG can cross the placenta, since they aren't advocating its use during pregnancy, but after. In fact, this sentence:
Quote:
The RhoGAM antibodies themselves do not persist for long in the mother’s circulation and so do not pose a threat to future pregnancies.
suggests to me that they assume readers are aware that RhoGam antibodies pose a potential threat to the fetus.

You'll have to tell me where to look in the third link. I did see mention that IgM doesn't cross the placenta, whereas IgG does, but I did not see any discussion of how that relates to RhoGam.
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#71 of 116 Old 01-05-2007, 06:20 PM
 
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I guess I don't have a very good eye for this stuff, what I saw was (on the first 2 pages, again, I didn't say the third link discussed RhoGam, just that it said IgM doesn't cross the placenta) an implication that IgG was the result of being sensitized, but that IgM was the result of RhoGam, implying that that was why RhoGam should be used.: But- I have admitted already that I am not the brightest one around here in reading these things, so I must've taken it wrong.

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#72 of 116 Old 01-05-2007, 06:22 PM
 
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Originally Posted by Peppermint View Post
I guess I don't have a very good eye for this stuff, what I saw was (on the first 2 pages, again, I didn't say the third link discussed RhoGam, just that it said IgM doesn't cross the placenta) an implication that IgG was the result of being sensitized, but that IgM was the result of RhoGam, implying that that was why RhoGam should be used.: But- I have admitted already that I am not the brightest one around here in reading these things, so I must've taken it wrong.
Heheheh! Everybody misses things sometimes. See how I very clearly missed you saying it was only the first two links?
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#73 of 116 Old 01-05-2007, 06:24 PM
 
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It's also never a bad idea to consult "evidence based medicine" when trying to figure stuff like this out.

http://www.cochrane.org/reviews/en/ab000020.html

That's a .8% difference.

http://www.cochrane.org/reviews/en/ab000021.html

Still not a huge difference, but better than less than 1%.

I loves me some Cochrane Collaboration.
See what actually works not only in theory, but in practice. What a brilliant idea!
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#74 of 116 Old 01-05-2007, 06:36 PM
 
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Plummeting- I figure I will get better at these things if I keep hanging out here .

Mamakay, thank you for those links. I really hope my OB will consider this with me, and I won't have to deal with "we will kick you out of our care if you refuse this".

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#75 of 116 Old 01-05-2007, 10:14 PM
 
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I was wrong. thank you for pointing this out to me. Rhogam is pooled IgG.

Based on *my* understanding and the studies I've read (some of which are posted above), I believe it is worth taking this shot. Overall, it
stops the immune system from mounting a response, which would be a lot worse since the activated lymphocyte would clonally proliferate and release a lot more antibody than what is administered in RhoGam. With the shot, the idea is only a small amount of Ab is needed to neutralize a small amount of Ag and shield it from the immune system. The amount that might cross through the placenta is inadequate to cause damage to the fetus based on the clinical trials, some of which I listed above, I can make a list of more if people are interested.. Serious adverse reactions are rare: from 1990 to 2000, during which time 2.9 million doses of one manufacturer's anti-D immune globulin were given, the
manufacturer received only 11 reports of adverse events possibly
related to the drug. Now, maybe it's possible that there were more adverse reactions than what was reported, I don't know.
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#76 of 116 Old 01-05-2007, 10:31 PM
 
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these are some of the articles i looked at:
(search terms: RhoGam, pregnancy, adverse events, fetal anemia, isoimmunization)


http://www.sciencedirect.com/science...062e318453928f
Quotes edited as they violate MDC's copyright policy

http://www.sciencedirect.com/science...cbb5308451844f
Quotes edited as they violate MDC's copyright policy

http://www.sciencedirect.com/science...2ad1b01b944600
Quotes edited as they violate MDC's copyright policy

http://www.ncbi.nlm.nih.gov/entrez/q...=pubmed_docsum
Quotes edited as they violate MDC's copyright policy

http://www.ncbi.nlm.nih.gov/entrez/q...=pubmed_docsum
Quotes edited as they violate MDC's copyright policy

http://www.ncbi.nlm.nih.gov/entrez/q...=pubmed_docsum
Quotes edited as they violate MDC's copyright policy
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#77 of 116 Old 01-06-2007, 12:31 AM
 
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Originally Posted by iamleabee View Post
Based on *my* understanding and the studies I've read (some of which are posted above), I believe it is worth taking this shot. Overall, it stops the immune system from mounting a response, which would be a lot worse since the activated lymphocyte would clonally proliferate and release a lot more antibody than what is administered in RhoGam. With the shot, the idea is only a small amount of Ab is needed to neutralize a small amount of Ag and shield it from the immune system.
First, when one chooses to accept RhoGam while still pregnant, they are without a doubt subjecting their child to antibodies that will cross the placenta and will do some damage - it's the amount of damage that's in question, not whether or not it actually happens. Anti-Rh antibodies destroy fetal blood cells in the spleen. Period. BUT, if one delays RhoGam until after delivery, there is only a slight, slight chance that their child will be exposed to the antibodies. So, a woman has to decide: If I choose to use RhoGam while pregnant, is the minimal possible benefit (see the Cochrane review) worth the 100% assurance that my child will be exposed to antibodies that will destroy some of his/her blood cells? I think RhoGam after delivery can be a good idea, but RhoGam before delivery in a perfectly normal, healthy pregnancy doesn't make sense.

Second, there are always more adverse reactions than are reported. I think that's a given with all drugs, all the time. I 100% believe, and I think most people in this forum will agree, that clinical trials always understate the risk. They find multiple ways to do this, but they always do it. Believe otherwise if you want, but then we can point you in the direction of information on the SSRI/suicidal ideation links and the Vioxx/heart problem links. Pharmaceutical companies have a long, long, long history of manipulating studies every way they can to make their products look more beneficial and less harmful than they actually are. In reality, they have an imperative to do whatever they legally can to make money for their shareholders. Unfortunately, cheating has been paying off for them. Until the government starts cracking down on that (yeah, don't hold your breath) it will continue to be profitable for them and they will continue to do it.

Editing because you were talking about reported adverse reactions. Of course we can assume there were more adverse reactions that were not reported, as well. Doctors consistently refuse to believe that problems are related to any particular drug or treatment that was given. I developed severe chest pain, difficulty breathing and greying of my vision while on medication as a teenager. The doctor told me it was in my head and I was having panic attacks, until I lucked out and it happened while I happened to be in a hospital one day. A nurse took my bp and it was through the roof - like to the point that they thought I was about to DIE. I had been experiencing that a couple times a day for over a month, but had been blown off by the doctor several times a week since the time I first told him. I guess if I hadn't been in the hospital that day, it would've continued until maybe I just died. Then what? I guess they would've said that I just had a weak heart all along and no one noticed it. This isn't uncommon. It happens all the time.
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#78 of 116 Old 01-06-2007, 01:46 AM
 
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Originally Posted by iamleabee View Post
I was wrong. thank you for pointing this out to me. Rhogam is pooled IgG.

Based on *my* understanding and the studies I've read (some of which are posted above), I believe it is worth taking this shot. Overall, it
stops the immune system from mounting a response, which would be a lot worse since the activated lymphocyte would clonally proliferate and release a lot more antibody than what is administered in RhoGam. With the shot, the idea is only a small amount of Ab is needed to neutralize a small amount of Ag and shield it from the immune system. The amount that might cross through the placenta is inadequate to cause damage to the fetus based on the clinical trials, some of which I listed above, I can make a list of more if people are interested.. Serious adverse reactions are rare: from 1990 to 2000, during which time 2.9 million doses of one manufacturer's anti-D immune globulin were given, the
manufacturer received only 11 reports of adverse events possibly
related to the drug. Now, maybe it's possible that there were more adverse reactions than what was reported, I don't know.
So, the risk difference between getting the shot and not getting the shot during pregnancy is .8%, right?
The risk is 1% of you don't get it, and it's .2% if you get it.
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#79 of 116 Old 01-06-2007, 03:15 AM
 
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I've heard numerous accounts of women testing different for rH same woman testing both + and - so I'm not so sure they even can tell which you are. I read up on it a while back. My mom told me that I am rH- from the test they did when I was a newborn. Maybe I am, maybe I'm not. Maybe I've "changed" over the years. I am not planning to get the shot unless something goes terribly wrong.

Here are a couple of the links I used, but it's been a long time since I've read them.
http://www.thebirthsource.homestead.com/rh.html

Rhogam Insert pdf

old MDC thread
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#80 of 116 Old 01-06-2007, 11:06 AM
 
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i haven't read through all of this yet, but i'm going to b/c i had the shots w/both dc both times "just to be safe", now i'm wondering if i should just do the one after IF baby is +. anywho, should we do a poll (maybe a new thread to get ppl to click on it) to see how many get the shot both times, just after or not at all???? that'd be interesting to see!
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#81 of 116 Old 01-06-2007, 11:09 AM
 
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I've read this whole thread and learned a lot of new things. However, it's really outside the scope of the Vaccination forum since it deals more with the efficacy and necessity of the shot before, during, and after birth rather than issues it might hold in common with other Vaccination discussions (mercury as a preservative, for example.) Therefore, I'm bumping you over to Birth and Beyond.

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#82 of 116 Old 01-06-2007, 12:44 PM
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Thank you AnnetteMarie for moving this here, b/c I am RH- and I don't really visit the Vax forum that much yet, and I am jut about at the point where I "need" to get the first shot... I am going to read through this thread more thoroughly for sure!!! And thanks to those who have posted b/c I knew very little about this...
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#83 of 116 Old 01-07-2007, 08:14 PM
 
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should we do a poll (maybe a new thread to get ppl to click on it) to see how many get the shot both times, just after or not at all????
Knowing what I do now (and hindsight is 20/20) I would NOT get the shot until after my child was born and tested Rh positive, and only then after some serious consideration. I had 3 shots of winrho during my first pg, all given by "competent" medical professionals. I was sensitized anyway. And I lost my first child at 40 weeks for unknown reasons (pathology tests showed a number of curious things happened including a massive inflammation of the placenta for again, unknown causes). I did go through a second pg (this one a sensitized one) and delivered a healthy (albeit slightly jaundiced) baby. I know sensitization is not desirable but it is also not the end of childbearing if it takes place. So, just my 2 cents but if I were to do it all again, knowing about how rhogam functions (the IgG) and its components (based upon the human plasma and possible infectious agents), I'd be more cautious about agreeing so readily to the shots.

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#84 of 116 Old 01-07-2007, 09:30 PM
 
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I had no idea it was a blood product the first time I had it either. Nice "informed consent", huh?
I had had six shots of it before I knew.
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#85 of 116 Old 01-07-2007, 09:48 PM
 
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Is it possible to have a + baby if both parents are -?

Lynisha ~Car Seat Tech-Scrapbookin'-Cake Decorating-semi-crunchy wife & SAHM to 2 + one on the way in Nov~

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#86 of 116 Old 01-07-2007, 09:57 PM
 
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Asked a dr. about this just today as I was curious - that the anti-D is recommended here during pregnancy, but isn't it a bad thing to have anti-D antibodies and an Rh+ baby inside?
Her answer was that the amount given is enough to talk one's body out of producing its own antibodies, but not enough to cause significant hemolysis in the baby at all. Further explained that Rh- people can be transfused with Rh+ blood as long as it is an acceptable proportion of total blood volume, and that even isoimmunized mothers do not always produce enough antibodies to cause problems with an Rh+ baby - this is why an isoimmunized person would have no treatment as long as titers were okay.

And last of all, I believe anti-D is made from the blood of deliberately Rh-sensitized males, not from accidentally sensitized women.

Editing to add: no, being neg. is recessive in my understanding, so two Rh- parents shouldn't be able to produce an Rh+ offspring. But something is telling me there may be more to it than that and I can't remember what...real helpful, right?
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#87 of 116 Old 01-08-2007, 12:47 AM
 
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Is it possible to have a + baby if both parents are -?
I did not think it was but over many discussions of Rhogam and RH status apparently it is possible although rare.
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#88 of 116 Old 01-08-2007, 11:23 PM
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Okay so I have read the whole thread at last and this is where I currently am: : More from my own mental sluggishness in trying to understand these different scientific terms and conditions than anything-- I feel like I'm rereading a difficult passage of my college science textbook, . I guess I have a lot more careful reading to do to decide about this.

My mom keeps telling me to double check b/c she's RH- but has the Du/ffy factor, so it was never an issue for her. I would NOT put it past my old OB's office to have completely missed this point. Also, I have GOT to get heel-dragging DH to finally get his stupid blood type from his old doctor or get tested, so we know where we stand!

Thanks so much to those who have posted here-- I've learned so much already about this thing I didn't understand at all (beyond what the drug co pamphlet-- not insert, just propaganda papers--told me).
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#89 of 116 Old 01-10-2007, 02:20 AM
 
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Quote:
Originally Posted by homebirthbaby View Post
Is it possible to have a + baby if both parents are -?
my MW gave me this link when I asked the same question

http://www.thetech.org/genetics/ask.php?id=114
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#90 of 116 Old 02-14-2007, 03:08 PM
 
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