Anti D injection

qo2cj1dsne8y4k

Hi, I'm a little bit confused and hope this is the right forum to ask this question.
I understand that if a rh - woman had a miscarriage, she is supposed to have an injection to prevent antibodies.

However, just say the woman didn't know this at the time of miscarriage, and didn't attend a hospital or a doctor, and didn't have the injection, is there any repercussions on her? is there anything a Dr can do afterwards in the event of not having had the injection.

Again, I'm not looking for medical advice. Just a better understanding

Neyite

LexieOnRale wrote: »

Hi, I'm a little bit confused and hope this is the right forum to ask this question.
I understand that if a rh - woman had a miscarriage, she is supposed to have an injection to prevent antibodies.

However, just say the woman didn't know this at the time of miscarriage, and didn't attend a hospital or a doctor, and didn't have the injection, is there any repercussions on her? is there anything a Dr can do afterwards in the event of not having had the injection.

Again, I'm not looking for medical advice. Just a better understanding

Probably best to get full advice from a gynae, but from my experience (I had to get anti-d twice and a good friend is also a haematologist who explained it to me)

Basically my understanding is: Foetal blood can transfer to the mother's bloodstream if she has a bump /fall during pregnancy, through miscarriage, or during birth. It appears to be that if the miscarriage was in the first trimester, the mothers immune system would not be triggered if the miscarriage was after that, a gynae or midwife would know for certain what the next step is.

The blood test that tests for antibodies is called a Kleinhaeur test. I got one - its a simple blood draw from inside the elbow and they test it to see if foetal blood has transferred over to you or not. The antibodies stay in the blood forever according to some sites I've looked at, so I reckon if you got this test done by your GP it will tell you whether or not you need anti-d from the start or not.

qo2cj1dsne8y4k

It's not for me but thanks for the post, very helpful.

Roesy

I miscarried my first at 7/8 weeks. At the time I didn't know I was rhesus negative so I was worried when I learned this after. I spoke to my gynae and midwife on my next pregnacy and both reassured me that before 12 weeks the anti d was not needed. I had a bleed at 8ish weeks during that pregnancy and 6ish weeks on my current one. Both times I was told I didn't need the anti d.

Digs

Sorry to hijack but am curious. I am also rhesus - didn't get the anti d during my first pregnancy as no bleeds etc and when she was born it turned out she is also R- so it wasn't needed.

I was wondering about getting my husbands blood tested just so as we would know what he is and the possibility of ever having a + baby. He asked our gp and she said they don't test for rhesus factor and wasn't very helpful beyond that! Anyone know how to go about it? Just for peace of mind for future pregnancies which we are considering at the moment!

Dolbert

Is he eligible to donate blood? That would tell him and it's a very worthwhile thing to do anyway.

Neyite

Digs wrote: »

Sorry to hijack but am curious. I am also rhesus - didn't get the anti d during my first pregnancy as no bleeds etc and when she was born it turned out she is also R- so it wasn't needed.

I was wondering about getting my husbands blood tested just so as we would know what he is and the possibility of ever having a + baby. He asked our gp and she said they don't test for rhesus factor and wasn't very helpful beyond that! Anyone know how to go about it? Just for peace of mind for future pregnancies which we are considering at the moment!

I remember asking my friend that. Even if he is RH+, a plus and a minus can still result in a plus or minus. I thought my partner could get tests and we would know but it can still go either way for the baby. So testing the dad is pointless and not done.

If your baby was RH- and you were also, then no antibodies would have been triggered - its only if the baby was RH+ and you had foetal /placental blood go into your bloodstream then the antibodies were created.

ETA: I was RH- and so was my baby, so the two Anti-D I got were ultimately not needed.

Digs

Thanks neyite. I think I'd like him tested on the offchance he is - though as in that case we could only have - babies... Am I correct in saying that?

Given that my daughter is - in my head I think there's a chance he is negative whereas if she was + he would have to be +!

Such confusion!

Digs

He should be alright dolbert. Didn't think of that thanks. Would they tell you your blood type when donating?

Neyite

Digs wrote: »

Thanks neyite. I think I'd like him tested on the offchance he is - though as in that case we could only have - babies... Am I correct in saying that?

Given that my daughter is - in my head I think there's a chance he is negative whereas if she was + he would have to be +!

Such confusion!

No, I thought that too but my haematologist friend told me two negatives can still give a plus. Or vice versa. So that's why even knowing the blood group and rhesus factor of the father is irrelevant.

Digs

Neyite wrote: »

No, I thought that too but my haematologist friend told me two negatives can still give a plus. Or vice versa. So that's why even knowing the blood group and rhesus factor of the father is irrelevant.

Ah ok that's that then! Good to know anyway.

qo2cj1dsne8y4k

So at about 14 weeks would you need one or is that considered over the first trimester? (As isn't 14 weeks really only 12?)
And even if it's father was rh - there's still a chance the baby could be a plus?
How late do they give the anti d after a miscarriage

Neyite

LexieOnRale wrote: »

So at about 14 weeks would you need one or is that considered over the first trimester? (As isn't 14 weeks really only 12?)
And even if it's father was rh - there's still a chance the baby could be a plus?
How late do they give the anti d after a miscarriage

Probably would be recommended to get one if the loss occurs at 14 weeks. Pregnancy counting starts from the date of the first missed period so 14 weeks (in laymans terms 12 weeks) is, to all intents and purposes, 14 weeks.
Yes, the fathers blood type is irrelvant.

Your last question, I honestly dont know - its something only an expert can tell you. But it should be given asap. If its a historical miscarriage, i.e, not happening or recently happened, then probably only a gynae can advise.

seamus

Neyite wrote: »

No, I thought that too but my haematologist friend told me two negatives can still give a plus. Or vice versa. So that's why even knowing the blood group and rhesus factor of the father is irrelevant.

That's kind of interesting because my wife refused Anti D on the basis that we're both O- so the child cannot be anything else. And nobody disagreed with us.
Except one midwife at an appointment (where I wasn't there) made the suggestion that if there was any possibility I wasn't the father, then my wife should get the injection

They were even good enough to take a sample of my blood and test it to be triple-sure and when it came back O- the midwife said, "That's grand so, you won't need it".

And she didn't get it.

Doing a little digging, the issue here would appear to not be that two Rh- parents can make a Rh+ child, but that there are certain rare forms of Rh+ which show up as Rh- on a standard blood test. So even if the father shows up as Rh-, you can't be absolutely 100% positive that the child will be too unless you also screen for the other types of Rh+.

Neyite

seamus wrote: »

That's kind of interesting because my wife refused Anti D on the basis that we're both O- so the child cannot be anything else. And nobody disagreed with us.
Except one midwife at an appointment (where I wasn't there) made the suggestion that if there was any possibility I wasn't the father, then my wife should get the injection

They were even good enough to take a sample of my blood and test it to be triple-sure and when it came back O- the midwife said, "That's grand so, you won't need it".

And she didn't get it.

Doing a little digging, the issue here would appear to not be that two Rh- parents can make a Rh+ child, but that there are certain rare forms of Rh+ which show up as Rh- on a standard blood test. So even if the father shows up as Rh-, you can't be absolutely 100% positive that the child will be too unless you also screen for the other types of Rh+.

Yep, I don't remember the specifics as explained by my friend, as I had baby brain and it was quite technical, but because bloods are her speciality, and she is quite senior and experienced in her field I trusted her knowledge over a midwife. I do remember her saying that the standard test is a basic one, and to know for sure there would have to be a lot more in-depth testing. I can only assume that the injection is overall more cost effective than the extensive blood tests.

It was stressed to me from the very first blood test that I needed to be aware of the circumstances where I might need Anti-D and to come in to them right away if anything happened.

The NHS is doing/considering a blanket type approach I think - giving every RH- mother the Anti-D irrespective of bumps and falls.

Digs

Neyite wrote: »

Yep, I don't remember the specifics as explained by my friend, as I had baby brain and it was quite technical, but because bloods are her speciality, and she is quite senior and experienced in her field I trusted her knowledge over a midwife. I do remember her saying that the standard test is a basic one, and to know for sure there would have to be a lot more in-depth testing. I can only assume that the injection is overall more cost effective than the extensive blood tests.

It was stressed to me from the very first blood test that I needed to be aware of the circumstances where I might need Anti-D and to come in to them right away if anything happened.

The NHS is doing/considering a blanket type approach I think - giving every RH- mother the Anti-D irrespective of bumps and falls.

I think this is how it's done in America anyway. Can't say I'd welcome it myself. I queried the injection with my consultant and he told me they could only advise, they weren't in the habit of strapping women to the bed and forcibly putting needles in them! Would be interested to see the protocol if a blanket type approach were implemented.

I just feel so strongly about not receiving the injection if unnecessary. Naturally if it were warranted I would agree to it and I realise in cases where it's a bleed or bump during the pregnancy it's warranted as babies blood type can't be determined.

pwurple

Digs wrote: »

I just feel so strongly about not receiving the injection if unnecessary. Naturally if it were warranted I would agree to it and I realise in cases where it's a bleed or bump during the pregnancy it's warranted as babies blood type can't be determined.

I hear you on this... I'm rh- as well, and have gotten 4 anti-d's at this point. 1 for a fall in my first pregnancy, one when baby was born RH+, another for a MC, and another one for another RH+ baby.

I'm not a fan of receiving blood products if avoidable. Plus, it means I cannot donate blood anymore. Which, as an RH- person, is in high demand I feel quite badly about. Luckily my husband stepped up and donates max amount he can now, kinda like it's on my behalf.

lonestargirl

There's a pretty good explanation of the RH- / RH+ recessive gene here.

tinkerbell

Neyite wrote: »

No, I thought that too but my haematologist friend told me two negatives can still give a plus. Or vice versa. So that's why even knowing the blood group and rhesus factor of the father is irrelevant.

Hmmm, I don't believe that's correct. If you're Rh- then both Rh genes that you carry are -. However, if you are Rh+ you can carry both + and -. The reason you are Rh+ is because + is the dominant gene.

In pregnancy, both parents pass down one Rh factor each. If mom is Rh- she only has - to pass down. If Dad is Rh- he also can only pass down -, therefore baby will only be Rh-. If however, Dad is Rh+ He can pass down a + or -. If + is passed down, + is dominant, so baby will then be Rh+. If he passes down the - then baby will be Rh-.

If Mom and Dad are both Rh+ then they could have a Rh+ or Rh- baby (Rh- if they both happen to pass down the - factor).

Phew! I need a rest now after that That's why a lot of women who are Rh- find out if their partner is Rh- also to avoid the Anti D. However, even if they've done this apparently hospitals won't take the chance to trust the couple and recommend the anti D anyway.

Neyite

tinkerbell wrote: »

Hmmm, I don't believe that's correct. If you're Rh- then both Rh genes that you carry are -. However, if you are Rh+ you can carry both + and -. The reason you are Rh+ is because + is the dominant gene.

In pregnancy, both parents pass down one Rh factor each. If mom is Rh- she only has - to pass down. If Dad is Rh- he also can only pass down -, therefore baby will only be Rh-. If however, Dad is Rh+ He can pass down a + or -. If + is passed down, + is dominant, so baby will then be Rh+. If he passes down the - then baby will be Rh-.

If Mom and Dad are both Rh+ then they could have a Rh+ or Rh- baby (Rh- if they both happen to pass down the - factor).

Phew! I need a rest now after that That's why a lot of women who are Rh- find out if their partner is Rh- also to avoid the Anti D. However, even if they've done this apparently hospitals won't take the chance to trust the couple and recommend the anti D anyway.

Actually if you read my subsequent post i clarified what i meant. Your explanation is correct but the blood test that is offered can still show some forms of + as a - thereby misleading couples. Seamus explains it well in his post, and also the link that lonestargirl provided.

tinkerbell

Neyite wrote: »

Actually if you read my subsequent post i clarified what i meant. Your explanation is correct but the blood test that is offered can still show some forms of + as a - thereby misleading couples. Seamus explains it well in his post, and also the link that lonestargirl provided.

Ah! Didn't see the post from Seamus - wasn't aware of that issue for some rare Rh+ people!

bluelemons

You can donate blood if you've had the anti d - from giveblood.ie

You will be deferred for one year if:
•You have received Anti-D Ig (this is an injection you may receive while pregnant-see your GP for more information) in or outside the Republic of Ireland.
•You have received intravenous immunoglobulin (this is a blood product administered to people with acute infections, immune deficiencies and inflammatory and autoimmune diseases) in or outside the Republic of Ireland, this excludes the United Kingdom