March 25, 2018

Rh Negative Pregnancy and ICT Positive

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.

ICT positive, rh negative

MY 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.” 

Reasons for the foetal blood to pass on to the mother

• Amniocentesis

• 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. Which was so scary. 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 my Rh negative 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. 

The Takeaway:

  • Rh negative pregnancy is different from others. 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 of my Rh negative pregnancy and the advice from my doctor. 

Rh Negative Pregnancy and ICT Positive


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17 thoughts on “Rh Negative Pregnancy and ICT Positive

  1. Thanks for sharing your experience. You have crossed a big hurdle. I can imagine the stress u would have felt during pregnancy, concerning about ur baby’s health every single moment. Glad that everything went well towards delivery.

  2. Hey, good to read this, my story is same except that my baby turned out to be Rh -ve too. So, the ICT had Truely turned out to be negative.

  3. Thank a lot you have given me hope to move on,am also rh neg,n pregnant,when ICT test was done it was positive n am so scared coz am not getng right advice, plz advice

      1. Hi.. I am priyanka.. and my ict came positive in the 34th week of my 1st pregnancy.. and it was negative during the 29th week.. my doctor has asked me to take ict again in 35th week.. I hope this is because of rhogham shot.. I feel very worried.. pls reply.. she made me worried about premature delivery as well..

          1. Hi..
            My wife ict came positive at 35th week of pregnancy.. and it was negative during the 29th week.. She has given Anti-d at 33 week and 2 week (35th week) after I ordered ict again… which comes positive.
            I hope this is because of rhoclone 300mcg shot..

            Doctor not telling me whether it is bcoz of Anti-d inj or due to real sensitisation.

            Really worried. planning for c-sector in 36 week.

          2. This looks a similar case like mine. There is nothing you do expect keeping calm and not worrying too much. Is the caesarean being planned because of ICT positive? Please get a second opinion before taking any decision.

  4. Yes, She is saying that baby can be taken out in 36-38 week and it is normal mainly if the 1st baby was delivered via c-section. according to her, there is no way to know whether it is real sensitisation or something else, so suggesting for preterm delivery (36-37week) to avoid any complications.

    I took second opening but all are saying that we can’t suggest as case is not observed by her since beginning.

    1. This is the second pregnancy? She is right that there is now way you can know if sensitisation has occurred or not. Best thing would be to keep observing the baby more frequently. And finally go as the doctor says. Try as much as possible to reach the full term. Unless there are other complications.

  5. Yes, This is second pregnancy and my first baby boy blood group is A+.
    That’s why she is saying to go for preterm (36week), according to her, 36 week is not a very early, 36-38 week considered as normal term delivery. Now i’m following doctor suggestions and planning to go for c-sec at 36 week 2 days.

    Thanks for you information.

  6. Hi Anchal,

    As you mentioned that level kept going down every week in your case and by the last month of my Rh negative pregnancy the ICT became negative. Could you please share the ratio in your ICT positive test. Was it 1:32 titer or just low like 1:8, 1:16 titer?

    I discussed this thing with my doctor and she said false positive after anti-d inj can be possible but in low level like 1:4, 1:6 or 1:16 but not high like 1:32.

    Kindly confirm what was in your case.

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