QuestionCan my second child develop problems later in life because I never had Rhogam shots with my 2 children. I am AB negative and their father was B positive.
AnswerDear Linda,
Rh incompatibility occurs only if you are Rh negative and your baby is Rh positive. In most cases, development of antibodies (sensitization) can be prevented, but if antibodies are formed, they will cross the placenta and can cause serious damage to the red blood cells of an Rh-positive baby. Since the father's blood is Rh positive, each baby has a chance of inheriting Rh-positive blood from the father. But if the babies are Rh negative, there is no need for RhoGAM.
Sensitization usually doesn't happen until after the birth of an Rh-positive baby. Therefore, in most cases Rh incompatibility is not a problem during a woman's first pregnancy and delivery of an Rh-positive baby. However, later pregnancies and deliveries may be affected unless the mother is treated with Rh-immune globulin (RhoGAM) after EVERY birth, miscarriage, and abortion.
Most often, the woman who is Rh-negative and carrying an Rh-positive baby will not begin producing antibodies until delivery when blood would potentially be mixed. However, the first dose of RhoGAM is typically given as an extra precaution around the 28th week of pregnancy. This can prevent rare cases where a woman would start producing Rh antibodies months before delivery.
Since you did not have RhoGAM with the pregnancies and are now likely sensitized (if your 1st baby was Rh positive), and if you did get pregnant again with another Rh-positive baby, the antibodies already in your blood could attack the baby's red blood cells. This can cause the baby to have anemia, jaundice, or more serious problems. This is called Rh disease. The problems will tend to get worse with each Rh-positive pregnancy you have. However, this is something that typically shows itself in infancy.
If you are Rh-sensitized, your doctor will watch your pregnancies carefully. You may have:
- Regular blood tests, to check the level of antibodies in your blood.
- Doppler ultrasound, to check blood flow to the baby's brain. This can show anemia and how severe it is.
- Amniocentesis after 15 weeks, to check the baby's blood type and Rh factor and to look for any potential problems.
Treatment of the baby is based on how severe the loss of red blood cells (anemia) is.
- If the baby's anemia is mild, you will just have more testing than usual while you are pregnant. The baby may not need any special treatment after birth.
- If anemia is getting worse, it may be safest to deliver the baby early. After delivery, some babies need a blood transfusion or treatment for jaundice.
- For severe anemia, a baby can have a blood transfusion while still in the uterus. This can help keep the baby healthy until he or she is mature enough to be delivered. You will most likely have an early C-section, and the baby may need to have another blood transfusion right after birth.
In the past, Rh sensitization was often deadly for the baby. But improved testing and treatment means that now most babies with Rh disease do survive and do well after birth.
I hope this has helped you and answered your question. I wish you well and apologize for the delay in answering. I usually try to answer in 48-72 hours but I have had a very hectic week.
Brenda
