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  1. #1
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    Default Anti d / rhesus negative - pregnancy no2

    I am rhesus negative and had anti d given throughout pregnancy with Ds. He ended up being the same blood type as dh rhesus positive so I had the extra injection after his birth.

    I know it is given to help your second pregnancy but how does it actually work? Or how do I know it did it's job? How will Ds being positive effect my next pregnancy? Will I come across any complications because of it?

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    There are many types of white blood cells that are involved in your immune system.
    The anti-D treatments are focused on controlling your B cell response.

    Each of your B cells recognises a different random chemical/protein shape to any other B cell. All of your B cells spend their time looking for the shape that perfectly matches their receptor. If they ever find their perfect fit then they become activated and start making antibodies that bind to the same shape target.

    Vaccinations are a way of selecting out those perfect-fit B cells so that you have pre-made antibody in your blood******. Antibodies can cross the placenta. B cells that have already been activated respond more quickly if their target ever comes along again later in your life.

    Antibodies have three main functions.
    1. Like a dodgem car bumper bar, bound antibodies get in the way between the bacteria or toxins in your blood and the cells of your body, stopping them from touching each other.
    2. Antibodies label their targets to get destroyed by other white blood cells, such as by macrophages (big eaters).
    3. Antibodies recruit pore-forming proteins from the blood to punch holes in the walls of antibody-labelled bacteria, which helps to kill them.

    With RhD+ babies (born to RhD- mothers) we need to make sure you don't manage to become immunised to the RhD+, because that basically means you've been vaccinated against all further RhD+ babies.

    So to prevent this immunisation we need to stop your B cells from seeing the first baby's RhD+ red blood cells. By giving you someone else's antibodies against the Rh+ the bumper-bar principle comes into play and your anti-Rh+ B cells don't ever get to see their target so never become activated. The other person's antibodies are given to you any time your immune system might have a chance to see your baby's blood, e.g. for medical procedures and birth.

    If you want to know if the anti-D injections used for your last pregnancy worked then it should be possible to get a blood test to see if you have lots of anti-Rh+ antibodies. If you don't have lots of these particular antibodies then the treatment worked, and immunologically speaking your next Rh+ pregnancy is exactly the same as your first, i.e. all your B cells are still naive towards that target.

    If the treatment didn't work then you will have lots of antibodies against Rh factor. Your antibodies will try to fight the baby's blood, just like a mismatched blood transfusion. Google says there are some treatments available, such as swapping the baby's blood for some Rh negative blood while it's still in the uterus. This might need to be done a few times during the pregnancy, and another transfusion might be needed soon after birth. You could also ask about plasmapheresis and immunosuppresion to reduce the amount of antibodies in your own blood and to make it more difficult to make more immune responses. The severity of the problem depends on how much of this particular antibody you have in your blood.

  3. The Following 2 Users Say Thank You to felicita For This Useful Post:

    BaronessM  (22-02-2012)

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    Thank you! That info was really helpful.

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    ah you reminded me i will need this shot when i get pregnant again, i totally forgot lol

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    What weeks do we get the shots again I can't remember?

    So we can either just get the shots or be tested to see If we need the shots again?

    That's some great info you have posted Thanx!

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    I had them at 28 and 34???? Then straight after my c section.

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    Quote Originally Posted by emmajayne View Post
    So we can either just get the shots or be tested to see If we need the shots again?
    The comment I made about testing was to answer the question regarding how to know if the previous shots worked or not - how to know if there would be complications for the next baby. The test was to see if your body was making its own anti-D.

    You do not want your body to make its own anti-D. You (Rh- blood) need the shots every time you have an Rh+ pregnancy to stop you from making your own anti-D. This is to prevent you from creating a problem for the next baby.

    Every time you ever know, expect or suspect that your Rh- immune system might get a chance to see Rh+ blood then you get the shot to prevent future problems.

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    sher1981  (11-12-2012)

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    Sorry I must have read something wrong!

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    np. It's an important matter so always best to check and double check.

    I probably let a bit of confusion get in because I didn't bother to mention that the effect of the shots wears off, whereas if you make your own anti-D (which you don't want to do) it will be replenished all the time.

    I don't know how long one shot works for, but based on the earlier post saying that the scheduled shots are at 28 and 34 weeks then it probably lasts a few weeks. It also depends on how much gets used up by binding to Rh+ blood too. So if you know that the baby's blood is getting into your body then you know you'll be using up the anti-D shots more quickly and will need more of them, or a higher dose. There are some guidelines in the Rhogam product information leaflet reminding doctors to give a higher dose under certain circumstances.

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    BaronessM  (22-02-2012)

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    Default helpful anti-d injections info

    i'm sure this is too late to be useful, but for anyone else out there the best article i read about anti-d injections was dr jennifer barham-floreani's blog post at www.welladjustedbabies.com/blog ... hopefully that will help someone out there

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    sher1981  (11-12-2012)


 

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