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Medical Forum / General / General / September 2006rh neg.....B neg
i am trying to understand if its possible for my wife and i to have a baby. she says no, but i think we can....i am Apos and she is B neg, rh neg....... is it possible? are there any treatments available? Possible, they just help out with the monkey bit during the pregnancy. >i am trying to understand if its possible for my wife and i to have a baby. > she says no, but i think we can....i am Apos and she is B neg, rh > neg....... > is it possible? > are there any treatments available? > i am trying to understand if its possible for my wife and i to have a baby. > she says no, but i think we can....i am Apos and she is B neg, rh neg....... > is it possible? > are there any treatments available? Having babies is not dependent on ABO blood types so I really don't know or understand your question. Your wife is B- would mean that when or if she does get pregnant then she would require RHo immune globulin in order to prevent her from developing Rh antibodies that might cause problems in an Rh+ baby. It is possible for her to have an Rh negative baby depending on your genetic breakdown. You are phenotypically RH positive but you may be heterozygous genetically carrying the RH negative gene. You may also be heterozygous as to your type A status also meaning you might carry the type O gene. Your baby might come out as type O. Apart from the RH factor the type B mother with a type A baby is not a problem. Routinely the mothers who have the most problems are type O mothers who have a higher concentration of anti-A and anti-B that can cause hemolytic disease of the newborn although not very severe in comparison to RH hemolytic disease. Blood types of baby cord bloods and checks for antibody coating the baby cells are always performed in type O mothers and all Rh negative mothers after delivery. There is no problems in conception with ABO although there might be problems in fetal development with Rh incompatiblity in a mother who has already developed an antibody to the RH antigen. Monitoring of such mothers is usually successful in delivering healthy babies. well my wife already has 2 children now, from before. her first is fine but her second, she has down synd. currently my wife is in the Philippines and my wife told me that they didnt giver any kind of shots at all knowing that she was rh neg B neg. but after her last was born, now she has a problem with her tubes. the doctors say she cant get preg and if she does then the big problem will be with her blood type...... sometimes i just really dont think they know what they are doing down thr in the Philippines...... >> i am trying to understand if its possible for my wife and i to have a baby. >> she says no, but i think we can....i am Apos and she is B neg, rh neg....... [quoted text clipped - 29 lines] >has already developed an antibody to the RH antigen. Monitoring of such >mothers is usually successful in delivering healthy babies. > well my wife already has 2 children now, from before. her first is fine but > her second, she has down synd. currently my wife is in the Philippines and my [quoted text clipped - 3 lines] > problem will be with her blood type...... sometimes i just really dont think > they know what they are doing down thr in the Philippines...... All prenatal workups include ABO Rh typing including antibody screen in checking for Rh antibodies. Downs syndrome is a chromosomal abnormality unrelated to ABO RH incompatibility. As many as 20% of miscarriages are related to numerical chromosomal abnormalitites unrelated to the above. Once a mother has developed anti-D in her system then subsequent babies who are RH positve will be affected in varying degrees. Not all babies are RH positive and the only way to know is actual testing of baby cells in-utero or testing of fetal tissue or following the concentration of antibody titer which is routinely done in all pregnancies involving this situation. Amniocentesis is then performed and parameters checked to see if the baby is in danger and subsequent preterm delivery undertaken or rarely in-utero transfusions etc. Granted these are high risk pregnancies but they are kept an eye on through out the pregnancy. These things are not routinely available in poor countries. It is obvious that Rhogam is not routinely used in such countries to prevent immunization in the first place. It is also a good thing that Rh negative blood types are rare in asia with the vast majority of the population being positive. Here in the states it is about 15% Rh negative. In asia it might only be 2% and thus they don't really care about such a low rate and don't worry about them, unfortunately. Problems with tubes etc are a different thing altogether. Thank you very much for your isight! it is very helpful! this makes my wife and i very hopeful! >> well my wife already has 2 children now, from before. her first is fine but >> her second, she has down synd. currently my wife is in the Philippines and my [quoted text clipped - 26 lines] >unfortunately. >Problems with tubes etc are a different thing altogether. > Thank you very much for your isight! it is very helpful! this makes my wife > and i very hopeful! You need to take her to an OB/GYN anyways for pap smears etc and they can answer your questions more directly. It is obviously helpful to have a verification of ABO antibody screen status. Without getting into specifics, it is possible for someone to have been typed as Rh negative in the past and with the newer monoclonal reagents in this country turn out to be Rh positive. We have seen several of those. There is also some Rh antibodies related to Rh negative mothers that are not as harmful as the single Anti-D and such pregnancies are treated like any other preganancy. This subgroup of mothers have anti-G antibodies which are a composite anti-D plus anti-C. Although both cases are rare above one needs to have the facts in front of them and testing is the only way to do that. Hopefully she hasn't developed any antibodies at all and you would be free of all of that. Good luck > Thank you very much for your isight! it is very helpful! this makes my wife > and i very hopeful! You need to take her to an OB/GYN anyways for pap smears etc and they can answer your questions more directly. It is obviously helpful to have a verification of ABO antibody screen status. Without getting into too much specifics it is possible for someone to have been typed as Rh negative in the past and with the newer monoclonal reagents in this country turn out to be Rh positive. We have seen several of those. There is also some Rh antibodies related to Rh negative mothers that are not as harmful as the single Anti-D. This subgroup of mothers have anti-G antibodies which are a composite anti-D plus anti-C. Although both cases are rare above one needs to have the facts in front of them and testing is the only way to do that. Hopefully she hasn't developed any antibodies at all and you would be free of all of that. Good luck she also had a miscarriage after her last born, which was a very complicated miscarriage, it happned at 5 or 6 months. blood was everywhere. she lost soo much blood that she was in the hosp for almost a week. they had a very hard time getting her blood. i am in the army, and i know that they use plasma for people that need blood. but they said it is very hard to find........any alternatives for getting blood when its needed? >Thank you very much for your isight! it is very helpful! this makes my wife >and i very hopeful! [quoted text clipped - 3 lines] >>unfortunately. >>Problems with tubes etc are a different thing altogether. > she also had a miscarriage after her last born, which was a very complicated > miscarriage, it happned at 5 or 6 months. blood was everywhere. she lost soo > much blood that she was in the hosp for almost a week. they had a very hard > time getting her blood. i am in the army, and i know that they use plasma for > people that need blood. but they said it is very hard to find........any > alternatives for getting blood when its needed? Well chromsome analysis can be undertaken of such miscarriages in the hopes of finding the reason for such miscarriages as they may be relevent to subsequent pregnancies. Miscarriage in general is common as I mentioned a rate of around 20% for each and every pregnancy with the cause being numerical chromosomal abnormalities. Genetic counseling is available when such information is available. Unfortunately Rh negative blood is rare and even in this country a shortage exists with such blood. Hard choices must be made when the blood supply is short. In general women of child bearing age are given priority for Rh negative blood. Older women and men who are Rh negative and require urgent blood then they are given Rh positive blood with a shortage of Onegs. Blood is given to save someones life and any subsequent problems associated with the immune production of Rh antibodies are hypotheticals dealt with later. The obvious danger is giving RH positive blood involves and RH negative person who already has an anti-D. This can lead to a hemolytic transfusion reaction and add problems to a person who already has medical urgent needs. The decision becomes don't transfuse anything and the person dies because of blood loss or give Rh positive blood and accept the possiblity of a transfusion reaction. Oneg is the universal donor so as a donor we love them but as a recepient then we can have problems. They may be started on Onegs and then switched to O pos later on depending on supply. These are difficult decisions that I have to make because I am in control of the supply and have to give the doctor options. It's either this or nothing. Summer months are bad and elective surgeries are cancelled. Plasma is a short term solution for a decrease circulating blood volume. In the long run one needs oxygen carrying red blood cells to prevent hypoxia and oxygen deprivation. There is no substitute for red cells and Rh positive blood cells would be transfused under such circumstances. There were clinical studies involving hemoglobin blood substitutes, such as Polyheme which is a pure hemoglobin solution, that were recently completed. These products have a long shelf life without refrigeration requirements. There is no blood typing requirements. They were being used in trauma patients out in the field. I hope to see the findings shortly. Apart from that studies were undertaken with Factor VII Novaseven infusions and the positive effect in decreasing blood products. This coagulation factor is very expensive as one little vial is about $4000 but is vital in decreasing the amounts of blood transfused. It serves as a fibrin plug and plugs the holes where blood is being lost. I have seen it do wonders with blood cell requirements as less blood is used after that. Good luck again
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