[cholderby]

I'm Rh negative, dh is Rh positive so there's a good chance that baby is Rh positive too. I like the idea of letting the cord finish pulsing on its own before cutting it, but would this further complicate matters with the whole Rh thing?
Anyone have any experience with this?
Thx

 

[daisycullen2003]

I haven't seen anything about this, but I do know my midwives will leave the cords (I'm having twins) attached as long as possible, but will need to cut them while there is still blood left so they can test the babies blood type using cord blood. I am RH- and husband +.
Lisa

 

[stafl]

It shouldn't be an issue, unless someone tries to yank the placenta out of your body before it's ready to be delivered, or there is some other sort of trauma that would mean your blood gets mixed with baby's. My baby's cord was cut only after placenta was delivered and the cord had stopped pulsing, and there was plenty of blood still in it to do typing. And I only agreed to type baby's blood in case she were to be rh+ that I could get rhogam within 72 hours of her delivery. I refused the injection unless test showed a need for it. Both of my girls were rh-neg anyway.

 

[plantmommy]

I'm rh-, dh rh+, cord was left intact, baby is rh+, and we've had no problems.

 

[obnurse]

Actually Stacy, the antibody an rH neg mom can make can pass across the placenta DURING pregnancy. THere does not need to be any mixing of fetal/maternal blood for this to happen. This is why the rhogam shot has saved the lives of many babies. In the past, if a neg mom was sensitized to the rH factor, her subsequent babies lives could be in big trouble. (mixing of fetal maternal blood as you described it is how the INITIAL event can happen, now fetal rH pos blood is in maternal circulation..and she makes the antibody) For the next and subsequent children..the ever present antibody can at will cross the placenta at anytime. That is why they had children die in utero from hemolysis.

The current goal is to keep all women from making the antibody at all, so there next children won't have to deal with the potentially fatal condition. As far as I know, delaying cord cutting won't be a problem, as long as the rhogam shot is given if mom is rH neg and baby is pos.

The only thing I have seen problems with, is IF there is a differing of blood TYPES, and mom is say O (carries both anti A and anti B antibodies`) and baby is say A. If blood is "milked' into the baby from the cord, extra blood that may have not naturally been in the babies system all at one time, can cause increased jaundice as the extra blood cells are broken down. Severe jaundice is not routinely seen though, so I am not implying that.

 

[stafl]

Quote:

Originally Posted by obnurse Actually Stacy, the antibody an rH neg mom can make can pass across the placenta DURING pregnancy. THere does not need to be any mixing of fetal/maternal blood for this to happen. This is why the rhogam shot has saved the lives of many babies. In the past, if a neg mom was sensitized to the rH factor, her subsequent babies lives could be in big trouble. (mixing of fetal maternal blood as you described it is how the INITIAL event can happen, now fetal rH pos blood is in maternal circulation..and she makes the antibody) For the next and subsequent children..the ever present antibody can at will cross the placenta at anytime. That is why they had children die in utero from hemolysis. The current goal is to keep all women from making the antibody at all, so there next children won't have to deal with the potentially fatal condition. As far as I know, delaying cord cutting won't be a problem, as long as the rhogam shot is given if mom is rH neg and baby is pos. The only thing I have seen problems with, is IF there is a differing of blood TYPES, and mom is say O (carries both anti A and anti B antibodies`) and baby is say A. If blood is "milked' into the baby from the cord, extra blood that may have not naturally been in the babies system all at one time, can cause increased jaundice as the extra blood cells are broken down. Severe jaundice is not routinely seen though, so I am not implying that.

I did look very deeply into this issue. That is not what my research turned up, but is what *one* doctor said to me when I asked, but he did not have any evidence to back up this opinion. My OB and my midwives all were very ok with me not having rhogam unless baby tested rh+ *after* she was born, and agreed with my findings that it was not necessary to have the shot during pregnancy at all. What you say only matters if mom is already sensitized to RHpositive blood. They tested my blood for rh antibodies, I have none, so did not need the rhogam during pregnancy, and only needed it after delivery IF baby were born with rh-positive blood. I am O-negative. Both of my girls are A-negative. Both girls did have jaundice, and my oldest was re-hospitalized because of it. That was more a factor of our nursing problems rather than blood incompatibility, according to the doctors and lactation consultants I saw.

 

[obnurse]

Sorry! The AFTER birth rhogam is what I was referring to! I think waiting until after birth and testing baby is fine! (as long as the pregnancy is fine, with no bleeding, trauma etc)
I was referring to a mama who would NOT take the rhogam even if DC was pos, and she became sensitized. (when the placenta separated..blood mixed..etc) With the next child, that baby would be at risk DURING the pregnancy, if she had not previously taken the postpartum rhogam and became sensitized (which of course not everybody would be sensitized)

 

[pamamidwife]

with RHneg moms, it's better to leave the cord intact. Leaving the cord intact until the birth of the placenta helps facilitate an even, smooth detachment of the placenta from the uterus, thereby REDUCING the risk of blood mixing.

your instincts are right on!

 

[cholderby]

Quote:

Originally Posted by obnurse The only thing I have seen problems with, is IF there is a differing of blood TYPES, and mom is say O (carries both anti A and anti B antibodies`) and baby is say A. If blood is "milked' into the baby from the cord, extra blood that may have not naturally been in the babies system all at one time, can cause increased jaundice as the extra blood cells are broken down. Severe jaundice is not routinely seen though, so I am not implying that.

Thanks for adding that. I'm O, DH is A. Figures, don't it?

Since we won't know the baby's blood type until after delivery, would it be better to cut?

 

[obnurse]

I really don't know the answer to that. I am sure that the ladies here can give you some info. I was only suggesting that it probably isn't a great idea to 'milk' the cord blood back into the baby.

 

[pamamidwife]

"milking" cord blood is vastly different from just not cutting the cord until after the placenta has delivered.

I would always err on the side of mother nature vs what we "perceive" to be risky.

 

[liseux]

I`d like to add that rhogam is also not 100%. It didn`t work in my case and I am rh sensitized. The good news is that outcomes are excellent for babies with hemolysis now, they are watched closely with u/s & can be transfused in utero. My sensitized baby just had jaundice, no transfusions thank God, but there are doctors who specialize in helping these babies get thru pregnancy safely.

 

[cholderby]

Quote:

Originally Posted by liseux I`d like to add that rhogam is also not 100%. It didn`t work in my case and I am rh sensitized. The good news is that outcomes are excellent for babies with hemolysis now, they are watched closely with u/s & can be transfused in utero. My sensitized baby just had jaundice, no transfusions thank God, but there are doctors who specialize in helping these babies get thru pregnancy safely.

Good to know. This is #1 for me so I don't think I'll have any issues this time around. God willing we will have lots more to come, though, so its good to know.