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Pregnant and having O negative blood group. Is it necessary to take anti D injection?

DOCTOR OF THE MONTH - Mar 2013
Mar 2013
User rating for this question
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Answered by
Practicing since : 1998
Answered : 5866 Questions
Question
HI DOCTOR,

MY BLOOD GROUP IS 0 NEGATIVE & AM PREGNANT WITH 1ST PREGNANCY & PREGNANCY IS 29 WEEKS 4 DAYS. MY HUSBAND HAS B POSTIVE BLOOD GROUP. MY GYNAECOLOGIST HAS DONE BLOOD TEST AT 21 WEEKS OF ANTIBODIES IN BLOOD & REPORT WAS NEGATIVE I.E. NO ANTIBODIES WERE NOTED IN BLOOD GROUP. I HAVE READ OVER INTERNET THAT ANTI - D INJECTION SHOULD BE GIVEN DURING PREGNANCY TO AVOID COMPLICATIONS BUT MY GYNAECOLOGIST HAS SAID THERE IS NO NEED TO GIVE INJECTION. I WANTED TO HAVE SECOND OPINION ABOUT THIS & WANTED TO KNOW WHAT COMPLICATIONS CAN BE THERE DUE TO 0 NEGATIVE BLOOD GROUP??
Posted Sun, 27 Oct 2013 in Pregnancy
 
 
Answered by Dr. Aarti Abraham 17 minutes later
Brief Answer:
SHOULD TAKE ANTI D SHOT.

Detailed Answer:
Hello XXXXXXX
Thanks for writing to us with your health concern.
When the wife has O negative blood group and the husband has a positive blood group ( as has happened in your case ), then complications might arise if the baby has a positive blood group too ( very likely as your husband has Positive blood group and Positive blood group is dominant in inheritance ).
Now the first baby will not generally have any problems.
During delivery or even sometimes during pregnancy, some amount of blood from the baby will go into the mother's circulation ( normally only blood from mother goes to baby and not vice versa ) , however during delivery , or even during pregnancy, a small amount may flow backwards from baby to mother.
In this scenario, the mother is exposed to the Positive group , and forms antibodies against it.
These antibodies will remain in the mother's bloodstream, and during the next pregnancy, again if the baby has Positive blood group, these antibodies will go to the baby, and will destroy the red blood cells of the baby.
During the first pregnancy also, if due to minor bleed , the mother already has formed antibodies , then they can even harm the first child.
Complications would arise such as - destruction of the red blood cells of the baby causing severe anemia, swelling of the tissues due to anemia, heart failure and ultimately death of the baby.
To avoid this, generally, a mother is given Anti D injection twice - during pregnancy around 28 weeks ( to neutralize any positive cells lurking around due to minor leak ) and repeated again after delivery ( to neutralize the positive blood cells of the baby transferred to the mother after delivery ).
This is a must to prevent complications to the baby and the future pregnancies.
There is no doubt that you should have an Anti D injection in this pregnancy , and around 29 weeks, this is the best time.
Please insist on it , and make sure your Gynecologist administers it to you.
Also, Anti D should be given within 72 hours after birth, once the blood group of the baby is confirmed ( if it is Positive ).
Please show your doctor the following link , though a qualified practitioner should not require convincing -
http://www.nhs.uk/Conditions/Rhesus-disease/Pages/Prevention.aspx
All the best dear.
Please feel free to ask for further clarifications.
Above answer was peer-reviewed by
 
Follow-up: Pregnant and having O negative blood group. Is it necessary to take anti D injection? 32 hours later

HI MADAM,

I MET WITH MY GYNAECOLOGIST TODAY & ASKED HER ABOUT ANTI - D INJECTION, SHE SAID THAT SHE WILL GIVE INJECTION AFTER DELIVERY IF BABY IS FOUND POSITIVE & DURING PREGNANCY SHE HAS DONE RH TITRE TEST WHICH HAS COME NEGATIVE & SHE WILL TEST AT REGULAR INTERVALS. SHE SAID SHE WILL GIVE INJECTION IF TEST IS FOUND TO BE POSITIVE AS SHE DOES NOT WANT TO GIVE UNNECESSARY INJECTIONS. SO PLEASE ADVICE ME WHAT TO DO??? AND ALSO I WANTED TO KNOW ABOUT CORD BANKING & ABOUT ITS BENEFIT. IS IT ADVISABLE TO GO FOR CORD BANKING.

 
 
Answered by Dr. Aarti Abraham 28 minutes later
Brief Answer:
DETAILED BELOW

Detailed Answer:
Hello again.
If the test is found to be POSITIVE, then there is NO NEED to give this injection, because once you are already immunized, no injection will work !!
It is very surprising that a qualified doctor is providing you with such erroneous information.
The injection is given only when the Rh titre has come to be negative.
PLease insist on the injection.
Cord blood banking is a controversial subject.
In the west, there are public cord blood banks, which is definitely advisable.
In India, there are private banks, and it is quite expensive to go for cord banking.
It is recommended for families in which there is high prevalence of diseases like leukemia, neurodegenerative diseases, thalessemia etc.
The benefit of cord banking is proven only for certain conditions , and it is in the experimental stage for a lot of conditions like diabetes, cardiovascular disease etc, for which it might be beneficial in the near future.
If you have a high prevalence of such diseases in your family, then go for cord blood banking, otherwise current scientific literature does NOT recommend private cord blood banking.
All the best to you always.
Above answer was peer-reviewed by
 
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