Every pregnancy is different and special in its own way. We all have our ups and downs and we need to stay strong and positive. During my childhood, my father got my blood group tested. He was worried to know that my Rh factor is negative. He was afraid that when I decide to become a mother, this Rh negative might cause troubles for me. Least did he know that his fear would become real and it would pose a threat to his first grand-child. We had to be extra cautious because my husband is Rh positive. I was ignorant about a lot of facts that could have affected my pregnancy. To my surprise, many doctors were ignorant about it too. I want to share my story to make everyone aware of some aspects of an Rh negative pregnancy.
I had an episode of spotting at 23 weeks into pregnancy. It worried me like hell but no cause could be found out. The baby was healthy and fine. I was given Rhogham injection because at the time of spotting doctors worry that the blood of the mother and the baby might mix up. At 28 weeks, when I was tested for ICT, it turned out to be positive. In simple words ICT determines if the mother’s immune system has developed antibodies against the foetal blood. When that happens, we say Rh sensitisation has occurred. During pregnancy, the mother’s and the foetal blood system is never shared. But sometimes a little blood passes on from the placenta to the mother’s blood. Now if both mother and the foetus have same Rh factor, there isn’t a problem. But if the mother has negative Rh factor and the foetus is positive, the mother’s immune system creates antibodies against the Rh factor. Also, the chances of a Rh positive foetus are more when the father is Rh positive. These antibodies attack the Rh factor as if it were a harmful substance. A person with Rh-negative blood who makes Rh antibodies is called “Rh sensitised.”
There are many reasons for the foetal blood to pass on to the mother. A few are
• Chorionic villus sampling (CVS)
• Bleeding during pregnancy
• Manual rotation of a baby in a breech presentation before labor
• Trauma to the abdomen during pregnancy
Most of the time, Rh negative mothers have no problem during their first pregnancy. But if any of the above incidents happen, chances are that the blood mixes and sensitisation can happen. And to check whether this sensitisation has occurred, ICT is conducted. The Rh antibodies can destroy some of the foetal red blood cells and cause foetal Haemolytic Anaemia where red blood cells are destroyed faster than the body can replace them. This can lead to serious illness and can sometimes be fatal for the foetus.
I searched about ICT and threats of Rh sensitisation frantically on the Internet and the results left me anxious and depressed. I could not get any source of right information. I was scared for the health of my baby. Coming from a doctor’s family I could reach many gynaecologists for advice. But every doctor I consulted gave me a different answer. Some created panic and others were hopeful that nothing will go wrong. Eventually, I had to consult with the doctors who were experts in this field. I had to get my blood tested every week to see the level of antibodies. Thankfully the level kept going down every week and by the last month of pregnancy the ICT became negative. So why was this test positive in the first place? Because I was given a Rhogham shot. There was no mixing of blood, in short there were actually no complications at all. I spent the entire seventh month of my pregnancy worrying about the health of the baby because I could not find any relevant information regarding Rh sensitisation and most the of the doctors misguided me. I do not want any of you mommies or would be mommies to go through what I experienced. My son is Rh positive as expected. And I got my second shot of rhogham post delivery.
- Get ICT done in your first trimester to know if you have any antibodies already present. If this test was done during my first trimester, I would have known that the positive test at 28 weeks was because of the shot given and not sensitisation.
- ICT should be repeated at 28 weeks before giving the Rhogham shot given at this time. This is mandatory if you want have a second baby. Because chances are that blood mixes during your first delivery. If your first baby is Rh negative. There is no need of the shot.
- If ICT is positive, the titre value should be considered. It is based on diluting the blood down to levels where the antibody can no longer be found. So the higher the number the more diluting needed which equals more antibodies in the blood. 1:1 is the lowest and it gets critical after 1:16.
- In case of sensitisation, take help of expert doctors in the field of Rh negative pregnancies. Most of the gynaecologists have not dealt with a lot of cases of this kind.
N.B : I am not a doctor. This information is entirely based on my experience and the advice from my doctor.
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