Antibodies: Anti-D + Anti-E

My son was born in August 2020. I failed to dilate past 5cm and there was “non-reassuring fetal status”, so they delivered via c-section. My son came out ghostly pale/not crying. He suffered from double nuchal cord and fetal-maternal hemorrhage. He had also aspirated meconium. My son went straight to the NICU and received a blood transfusion. He is a very healthy and happy 4-year-old now, we are so thankful. After birth, they did a KB stain test and found that 19% of my son’s A+ blood was in my system (I am A-). In the 72 hours after my son was born, I received 11 shots of RhoGAM to prevent sensitization, but it did not prevent it. One of the most frustrating parts of my journey is that I do feel I asked the right questions prior to preparing to have my daughter in 2023. I met with MFM, a hematologist, and OB. I asked a lot of questions – “is my blood ok? what blood type am I now? what does anti-D and anti-E” mean?” One OB told me it meant I had received a lot of RhoGAM (which I believe is true in the first 6 months after, but this was 2 years after). I asked if it was safe to have another child. They all assured me yes. No one mentioned alloimmunization or HDFN. I was referred to MFM around 19 weeks pregnant with my daughter. I thought I was being referred for short cervical length (which was an issue during my son’s pregnancy). At this appointment 2/13/23, the bomb was dropped about alloimmunization and HDFN. From this point, I received weekly MCA dopplers. We never required an inuterine transfusion. My daughter was born at 37 weeks. The NICU doctor did not want to test her blood at birth or 4-6 hours after. He agreed to after I strongly advocated for it (he definitely thought I was a crazy mom). Her bili at 6 hours old took her to the NICU. On day 3 in the NICU, we were 1.1 points away from an exchange transfusion. My daughter spent 23 days in the NICU. She received 2 rounds of IVIG, lots of phototherapy, and 2 regular blood transfusions. Before the first transfusion, the NICU doctor did not want to transfuse because the blood “would feed the antibodies.” I advocated that if we transfuse with O- blood, the antigen negative blood could only help. Throughout this whole journey, there are 13 strong moments, like the one mentioned above, where I advocated and/or felt our doctors were not fully on top of our situation. My daughter is now a healthy, happy, energetic girl. Again, we are so very thankful.

How Can Health Providers Help?

 Thank you for everything you do. There were some incredible doctors throughout our journey. Even though some were not always correct in course of action, they listened to me. Please listen.

How Can Scientists Help?

 Education and advocacy for this condition. I am so happy the Allo Hope Foundation was established 5 years ago! Thank you for all you do!

What Would You Tell Other Patients?

Do your research and advocate. Do not be afraid to be the crazy mom. Listen to your instincts. Try not to let this dull your pregnancy. Find joy. Take the pictures (I hardly took any pictures during my allo pregnancy). Have the baby shower.