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Is It Required To Take Anti -D Vaccines During 2nd Pregnancy As I'm AB -ve And My Husband A+ve ?

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Posted on Thu, 26 Apr 2012
Question: Hi, am 25 years old female. am 7 weeks pregnant now.My blood group is AB -ve and my husband's blood group is A +ve. I had an abortion 1 year back while I was 8 weeks pregnant. I took an anti -D injection at that time. Is it required to take any more anti -D vaccinations now during my second pregnancy to avoid risks?
doctor
Answered by Dr. Mohammed Tauseef (2 hours later)
Hi XXXXXXX

Thanks for the Query.

I would like to know few more things which would help me in suggesting you better:
1.) During which week of your Previous Pregnancy did you receive the Anti-D injection?
2.) Did you receive it after the Abortion?

Your history suggests Rh Incompatibility which happens when a Rh negative woman marries a Rh positive Man. The Problem arises when she gets Pregnant. The growing fetus can inherit the Rh Positive antigen from Father. The Mother's blood recognizes the fetal blood as foreign body and starts producing antibodies against it which enter the fetal circulatory system through placenta and start causing massive red blood cell destruction in the fetus which leads to a condition called "Hydrops Fetalis".

To Prevent this condition, anti-D that is RhoGAM injection was introduced to treat pregnant mothers at risk for Rh incompatibility, which has reduced its incidence to a significant extent.

You have already been sensitized by your Doctor by giving you a Anti-D injection in your previous pregnancy. In addition to this, you again will require treatment of Anti-D if your baby is Rh Positive, before and during delivery and will require it for subsequent pregnancies if the baby is Rh positive as the treatment of anti-D is good only for the pregnancy in which it is given. You will require it even if you happen to have a Miscarriage or abortion.

Speak to your Doctor and schedule regular check ups so that your doctor may know if the fetus is doing fine or developing this condition (Hydrops Fetalis) through
1.) Physical examinations
2.) Amniocentesis
3.) Ultrasound scans.

In the Ultrasound scans your Doctor will look for
1.) Size of the placenta
2.) Amount of Amniotic Fluid
3.) Fetal Abdominal swelling to rule out Hydrops Fetalis.

If the antibodies have developed, your baby may be delivered on time, followed by a blood transfusion. In severe cases, your baby may be delivered early but after the blood transfusion while the baby is still in the uterus which is called "Intrauterine fetal blood transfusion". Your treating Doctor would know better and will take necessary action depending upon the situation.

One thing I would like to ask you to do is to stay calm and follow the treatment regularly.

Hope I have answered your Query, I will be available to answer your Follow up Queries.

Wish you Good Health.

Take Care.
Above answer was peer-reviewed by : Dr. Ashwin Bhandari
doctor
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Follow up: Dr. Mohammed Tauseef (2 days later)
Dear Dr. XXXXXXX Tauseef,

Thanks a lot for clarifying my doubts.
I took anti D injection after my abortion(during my first pregnancy which lasted for 8 weeks).

I heard like, if the abortion happened within first trimester , then anti D is not necessary. So i thought my current pregnancy will be fine since my abortion happened within first trimester and also i took anti D immediately after that.

Can you Please tell me whether it is still necessary to take anti-D during this pregnancy? AFTER my delivery surely i will take anti-D, but want to know whether it is really required DURING pregnancy, since i don't want to disclose with my family doctor about my previous abortion. But if it is going to be any harm for my current pregnancy then i don't want to take risk.

Waiting for your reply,
Thanks.
doctor
Answered by Dr. Mohammed Tauseef (23 minutes later)
Hello XXXXXXX

Thank you for Writing Back.

I Would like to ask you one thing here, Who has told you that you don't require Anti-D Injections if you have had a abortion within First trimester?

I would like to repeat it once again that,
If you conceive again, and you have a Rh Positive fetus, chances will be there that your Body produces the Antibodies against your Baby's blood irrespective of the Anti-D Injection given in your Previous Pregnancy as the treatment of anti-D is good only for the pregnancy in which it is given. You will require it before and during delivery, your treating Doctor will explain it to you better.

He/She will examine you and do Amniocentesis and Ultrasound scan to know the health of the fetus and will monitor it's health continuously as it is a High risk Pregnancy. Hence schedule regular check ups with him/her.

Kindly don't hide anything from your Family Physician and treating Doctors as it may be harmful. Kindly speak out to them and there is no harm or Risks involved in this. If you conceal anything, it is harmful to your Baby's health.

This condition is almost completely Preventable, you will have to receive Anti-D Injections for every Pregnancy, and it is usually given in the second trimester.

Wish you Good Health.

Take Care.
Above answer was peer-reviewed by : Dr. Radhika
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Answered by
Dr.
Dr. Mohammed Tauseef

General & Family Physician

Practicing since :2007

Answered : 1337 Questions

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Is It Required To Take Anti -D Vaccines During 2nd Pregnancy As I'm AB -ve And My Husband A+ve ?

Hi XXXXXXX

Thanks for the Query.

I would like to know few more things which would help me in suggesting you better:
1.) During which week of your Previous Pregnancy did you receive the Anti-D injection?
2.) Did you receive it after the Abortion?

Your history suggests Rh Incompatibility which happens when a Rh negative woman marries a Rh positive Man. The Problem arises when she gets Pregnant. The growing fetus can inherit the Rh Positive antigen from Father. The Mother's blood recognizes the fetal blood as foreign body and starts producing antibodies against it which enter the fetal circulatory system through placenta and start causing massive red blood cell destruction in the fetus which leads to a condition called "Hydrops Fetalis".

To Prevent this condition, anti-D that is RhoGAM injection was introduced to treat pregnant mothers at risk for Rh incompatibility, which has reduced its incidence to a significant extent.

You have already been sensitized by your Doctor by giving you a Anti-D injection in your previous pregnancy. In addition to this, you again will require treatment of Anti-D if your baby is Rh Positive, before and during delivery and will require it for subsequent pregnancies if the baby is Rh positive as the treatment of anti-D is good only for the pregnancy in which it is given. You will require it even if you happen to have a Miscarriage or abortion.

Speak to your Doctor and schedule regular check ups so that your doctor may know if the fetus is doing fine or developing this condition (Hydrops Fetalis) through
1.) Physical examinations
2.) Amniocentesis
3.) Ultrasound scans.

In the Ultrasound scans your Doctor will look for
1.) Size of the placenta
2.) Amount of Amniotic Fluid
3.) Fetal Abdominal swelling to rule out Hydrops Fetalis.

If the antibodies have developed, your baby may be delivered on time, followed by a blood transfusion. In severe cases, your baby may be delivered early but after the blood transfusion while the baby is still in the uterus which is called "Intrauterine fetal blood transfusion". Your treating Doctor would know better and will take necessary action depending upon the situation.

One thing I would like to ask you to do is to stay calm and follow the treatment regularly.

Hope I have answered your Query, I will be available to answer your Follow up Queries.

Wish you Good Health.

Take Care.