Antibody Isoimmunisation and other such language…

We have been very blessed to be able to have children. My first pregnancy was a little bit of a rollercoaster. In the first trimester we thought we lost Jayden and when it came time to deliver, an emergency c-section was needed. Jayden became my first miracle baby.

My second pregnancy, sadly ended in miscarriage. I don’t know exactly how far along I was, but I can tell you that it was a very heartbreaking experience. It is not easy to talk about still and I have found many women struggle to talk about losing a baby. I am so thankful to know that the little one I never met is in the arms of my wonderful God!

When I became pregnant with Jimmy just a few months after the miscarriage; it was discovered that I had been “sensitized”. My first thought was, “What does that mean?” So, the research began.

I am Rh negative blood type. Typically, a woman with negative blood is given the rhogham shot to prevent sensitization. I received the shot with Jayden’s pregnancy. But because of circumstances with the miscarriage, I did not receive the rhogham shot. My negative blood mixed with the baby’s positive blood and my blood became sensitized.

Negative blood sees positive blood as a “cancer type” threat and develops anti-bodies to kill and destroy all positive blood cells. Basically this means, when pregnant, my body attacks the baby attempting to destroy the very blood that makes us able to live. The antibodies in my blood will break down the babies blood until the baby becomes anemic. If the anemia is untreated, the baby’s organs will slowly stop functioning and the end result is a still born baby.

There are several types of anti-bodies. I started out with Anti-D and Anti-C. But towards the end of my pregnancy with Jimmy I had developed Anti-E and Anti-F as well.

Ok. So you are probably wondering as I was, what in the world do you do about all of this?!

The typical management of sensitized pregnancies is as follows:

First Trimester:
Monitor antibodies by mother’s blood work. Antibodies are measured as titres. Anything above a 32 is considered to be critical.

Second & Third Trimester:
Once critical level is seen in mother’s blood beginning at 18 weeks, ultrasounds are performed to measure whether the baby is becoming anemic.

During the ultrasound the Middle Cerebral Artery (MCA doppler) is focused on. This is the main artery at the top of the middle of the babies head. The ultrasound measures how fast the blood is flowing to gage signs of anemia. Several readings are taken and an average measurement is determined. There is a chart used to determine if the readings were average flow or anemic flow.

If the ultrasound shows signs of anemia in the baby, the next step is Intrauterine Blood Transfusion (IUT). This procedure gives the baby a blood transfusion while in the womb giving them much needed red blood cells. The IUT is done in labor and delivery at the hospital and done while mom is awake using an ultrasound to find the umbilical chord and amniocenteses type needles to administer the transfusion. (Jon calls them horse needles)

Jimmy received two IUTs. The first at 28 1/2 weeks and the second ten days later. He needed a third IUT but I was in labor and my doctors determined the best step was to deliver at 32 weeks. He stayed 2 weeks in the NICU and received 5 more blood transfusions before he was 3 months old.

So, here is the scoop on this pregnancy so far. I started the pregnancy with Anti-D, C, and E. Anti- D and C were both way above the critical level at eight weeks. They have both doubled since then. This week we will be scheduling our first ultrasound to begin measuring the MCA level for this baby.

I hope I haven’t confused you or bored you. But I wanted to have a reference post for those asking about  what this pregnancies risks were.

We know that the Lord is in control. Jon and I have perfect peace and have been blessed with some really awesome doctors! Last ultrasound at 15 weeks showed a healthy baby in every way they could see. (Praise the Lord!) It is a little easier this time around, knowing a little of what to expect. I will keep you all updated here as often as possible. Thanks for all the prayers and support!

Much love.

Keikilani