I am rh sensitized to anti E. There's no rhogam for what I have, it's just one of those things.
I was sensitized during a pregnancy. We're not sure when, since there were no signs of bleeding or anything. At the begining of my pregnancy I was not sensitized, and in the delivery room they discovered that I was. The Coombs (think I spelled that right) showed that my ds was not affected, but he **** had a billi level of 21 at 3 days of life.
I am now being monitored very carefully by my OB and once my titers get to 1:4 I am risked out of our small hospital and will be seen at a large medical facility. The ACOG strongly recommends that all rh sensitized pregnancies not go past 38 weeks, and after reading the literature I agree. The risk of sudden death in utero go way up, and it's rare for a 37 weeker to die. My son was a 37 weeker, BTW, and was a totally healthy newborn.
Depending on my titers, I will need to get u/s towards to end to check for edema and other signs of hemolysis. If that doesn't look reassuring, then an amnio is the recommended course of action, and if that looks bad they will either deliver immediately, or try an in utero exchange transfusion, but the risks of death with that are very high.
Things aren't over once the baby is born, however. I am guaranteed a 3 or 4 day hospital stay because of jaundice. Both my kids, who were not affected by rh sensitivity had billi levels over 21 at 3 days of life. We were able to take them home with a blanket, but that won't happen this time. If the lights can't take care of the billi, an exchange transfusion may be in order, and for some reason that drs aren't sure of, babies with born to sensitized mothers are at a higher risk of kernicterus (think I spelled that wrong) at the same billi levels as babies born to mothers who aren't sensitized. Then of course there's an increased risk of hemolytic disease of the newborn, death, and edema, but I'm sure you knew that.
In short, it becomes a medically managed nightmare, not just during pregnancy, but also after delivery. I don't mind all of the extra tests I have to go through, but it breaks my heart that my little one will have to be laying alone under lights for several days instead of being at home in my bed being snuggled by my husband and myself.
And for what it's worth, it is illegal in my state to give a vaccine with thimerasol in it. I really wish rhogam would have been an option for me, but it wasn't, and now I'm stuck dealing with something I never thought I would have to.