If you are rhesus negative, this will be identified with a blood test as part of your booking-in appointment during your first trimester. This blood test will confirm your blood group and check your rhesus status.
Your blood will also be checked for rhesus positive antibodies, which may have come from your first pregnancy, even if you experienced a miscarriage or a termination. If there are no positive antibodies, you will be offered anti-D injections in your third trimester.
If there are positive antibodies in your blood, you will be offered additional monitoring throughout your pregnancy.
Anti-D Injections
The recommendation for pregnant women who are rhesus negative (without antibodies) is to receive either:
- 1 higher dose injection between 28-30 weeks
or
- an injection at 28 weeks & another at 34 weeks
Your blood doesn’t normally mix with your baby’s blood during pregnancy as the placenta acts as a barrier but an anti-D injection can also be offered if you are rhesus negative and you:
- have a bleed
- experience a blow to your abdomen due to a car accident, walking into something or a fall
- need a procedure such as CVS/amnio or turning a breech baby with ECV
The aim of the anti-D injection is to prevent your body from making antibodies should your baby’s blood mix with yours – it will destroy any of your baby’s blood cells which have made it into your circulation.
This is why anti-D injections won’t be given if your blood already contains antibodies – anti-D can’t remove antibodies that are already there.
What does being Rhesus Negative mean for your baby?
If you are rhesus negative and your blood doesn’t contain antibodies, complications are rare for your baby.
However, if you experience sensitisation – when your baby’s blood mixes with yours during pregnancy or birth and you produce antibodies – this can be a serious issue in future pregnancies. The antibodies you make can cross the placenta and attack the blood cells of your baby – this is called haemolytic disease of the newborn (HDN).
This is why the anti-D injections are important – they work to protect any future pregnancies – and it is why HDN is now very rare.
If your blood contains antibodies, you will be offered additional monitoring throughout pregnancy and your baby may need additional care when he is born.
Your care if you are rhesus negative…
* you will be offered anti-D injections in pregnancy
* your baby’s blood will be tested at birth – if your baby is rhesus negative, you will be offered another anti-D injection
* speak to your midwife and ask questions to better understand your rhesus status and your care during pregnancy and when your baby is born
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Copyright: Janine Smith