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Positive for Rh antibodies In first pregnancy never given rhogam before blood was taken

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Help make sense of possibilities and if this is something to be of concern or not or if it could be a false positive:

 

first pregnancy due in August - no previous miscarriages no blood transfusions etc.

 

2011 college class - did a lab and blood type was A+ (could have easily messed this up)

 

feb 2020 pregnancy appt tested A- and negative for antibodies (13 weeks pregnant)

 

June 2020 pregnancy appt tested A- but positive for “Passive anti D” antibodies (29 weeks pregnant)

 

NOTE: doctors are super concerned and sending for ultrasound. Lab just assumed the result was expected because RHOGAM was given the same day BUT rhogam was given AFTER the blood was drawn So WAS NOT A FACTOR. Docs were waiting on a report of the titre but the lab never ran it. They said that because they already gave rhogam they couldn’t accurately get a titre now if the redid the blood draw. Rhogam was never given before in patients life. No history of any trauma, no accidents... everyone is confused. Please help make sense of this, it is driving me crazy.  

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I would really question the time of draw versus when the rhig was given. We had a similar situation and when all said and done it ended up she was injected before the blood draw.

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I am the patient in this case. Rhogam was 100% given after the blood was drawn and had never been given before that day. 

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Since they have given rhogam since the original sample will taking another sample tell them anything? Or will they have to do multiple to compare? 

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First of all, please do not worry.  IF you do have anti-D antibodies, and they are real antibodies, this is only one of a number of tests that the doctors will do during your pregnancy to make sure everything is going OK with your baby.  

What they should do is recheck your blood for anti-D levels now and again in about 4 weeks' time to see if there is any change.  It will show anti-D because of the Rhogam, but the important thing is to see whether the level increases significantly over time.  Also, even now, if it is very high (VERY unlikely) then that would indicate it's real anti-D as opposed to the Rhogam.

Ultrasound is a good idea.  It is usually done anyway during pregnancy, but it will also show if something is happening that they need to react to.

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Weekly ultrasounds and nst thru biweekly appts. Most recent ultrasound showed no signs of hydrops or any other issues thankfully, aside from 1.7 MoM, next day another ultrasound MoM dropped to 1.3. Could need IUT Between now (32 weeks) and 34 weeks depending on how these numbers change, after that will just induce if needed, will be induced before 37 weeks for sure at Mfm hospital with nicu. Re-ran titer - 1:256 (said they don’t dilute further beyond this). Given it was negative at 13 weeks, they have no idea how it happened given it was previously negative and no reason for it to have ever been positive. MFM said I’m only the second he’s ever had to have this in a first pregnancy. Doc said lab that ran the original bloodwork has changed their procedures bc of this case, so that is good! 

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