Hello, I am 20 and pregnant with my first child and first pregnancy, 21 weeks gone. I was told by my doctor at 9 weeks that i had anti Cw and that i was K kell negative. My doctor doesnt seem to be able to answer my questions and only told me to ask my midwife (whom I have only seen once) who also couldnt give me any information and only told me to ask my doctor. My blood group is A pos Rhesus D. I know that my blood was previously healthy as i have donated blood since i was 17.

If anyone can give me some, ANY information, it will really help. if you need to know anything else let me know

Thanks

Bianca

90% of caucasians are Kell negative - not to worry. Anti-Cw is fairly rare (I think only 2% of individuals ar Cw+). You must have been sensitized to the Cw antigen either by pregnancy or transfusion. The literature suggests that anti-Cw may be naturally occurring, i.e., develops without exposure to red blood cells. It may be clinically significant. I would suggest that you have the father of your child tested for the Cw antigen. If he is negative then your child should also be Cw negative. If this is the case, your child is not in danger from this antibody. If the father is Cw+, your pregnancy will have to be monitored more closely to guard against some form of Hemolytic Disease of the Newborn (your antibody attaches to the baby's red cells and decreases their survival). Your physician should be providing this information to you. If you have any other questions, you may email me at dsaikin@littletonhospital.org

Bianca,

I might suggest that you print what David Sakin has written and have it available whenever you talk to your physician or other health care provider. I agree that your physician should be researching (if necessary) and providing more information to you. Is the laboratory that performed this testing the same facility where you will be be delivering your baby? If not, it is important that they have access to this information.

Edited April 16, 200916 yr by L106
Corrected typo.

Hopefully by talking to your provider you will get the answers that you need, if not try calling the blood bank at the hospital you will be delivering at and speaking to the supervisor about getting the pathologist at that hospital involved. The pathologist should be a good resource for your provider should they have questions about the possible implications of Anti-Cw. Just out of curiosity where are you located?

Thanks guys for replying!

I live in Greenwich, London. I havent ever had a transfusion or previous pregnancy. My first trip to the hospital for me was for my first scan at 12 weeks. I would like to add that I am mixed race, mother welsh and father jamaican and i wonder if this is of any significance. My partner is Dominican, so the baby is only a quarter caucasian, what is the percentage of black people with kell negative and Cw? Thanks, yes i think I will book my partner for his blood to be tested also.

Bianca

Kell and Cw are about 2%+ in Blacks. (AABB Technical Manual)

Can i add...

in my Rh phenotype results, aswell as the Kell neg, there is probable R1R1 (C+D+E-c-e+)

what is this?

thanks

Dear Bianca,

the most important thing is - DON'T WORRY. Sometimes the lab puts things in reports that are totally routine (for us), and we forget that it can look scary to anyone who doesn't work in a lab. And sometimes the doctors don't always understand the results. (I can remember, when I was pregnant, i used to spend 10 minutes with the doctors checking me over, then another hour discussing results that they didn't understand). All of these things that you report - Kell, Cw, R1R1 are different blood groups. Most people know about ABO and Rhesus blood groups (ie if you are O+, for example, or A-), but there are many other blood group systems (or, if you like, 'families' of blood groups); and each blood group system has a number of different possibilities within it - each 'possibility' is called an antigen. All of these antigens sit on our red blood cells. C,c,E,e,and Cw are all different possibilities (antigens)within the Rhesus system (family). Having one or the other possibility has no more significance than the fact that you have brown eyes or blue eyes - it's just part of your genetic makeup. Nor does it make any difference as to how your red blood cells work. So, the fact that you are R1R1 (which is just another way of saying C+D+E-c-e+) just means that you have the antigens C, D and e, but you don't have E or c. The only reason that this is important is that, when we are exposed to antigens that we don't have, then sometimes we can make antibodies against them. Antibodies are part of the body's immune system (defenses), and are really designed to protect us from infections. So, for example, if we have chickenpox, we make antibodies against it. Then, if the chickenpox virus tries to infect us again, our antibodies are ready and waiting and they destroy the chickenpox before it gets a chance to infect us a second time. Our immune systems can make antibodies against any antigens that are 'foreign' - that means, any antigens that we don't have on our own cells. So, in theory, you could make antibodies against E and c as well as K (which is another antigen belonging to a different 'family' - the Kell family) because you don't have these antigens. But - it is quite difficult to make these antibodies. The body does it quite reluctantly. Secondly, you first have to come into contact with the antigen. The ways we normally come into contact with 'foreign' blood group antigens is through pregnancy (becasue the baby inherits some blood groups from you, and some from the baby's father) and blood transfusion. This is why every pregnant woman is checked to see whether she is making antibodies against these foreign antibodies. If these antibodies are present, then they can attack the baby's red blood cells and make the baby anaemic. This is very rare. It used to be quite common, because of anti-D antibodies being made by Rhesus negative women, but there are now vaccinations that can usually prevent this. In your case, you can't make an anti-D because you are D+; that means, you have the D antigen - so it isn't 'foreign. But you DO have an anti-Cw. Your doctors should monitor this, just to make sure, but you should not worry unduly - especially as you have never been transfused or been pregnant. The Cw antigen also exists on various substances in the environment, and sometimes, our immune system gets tricked into making these antibodies to things that look like blood group antigens but aren't. This is probably what has happened in your case. The chances that your baby is Cw+ (in other words, has the Cw antigen) is quite small (about 2% of the population are Cw+); and even if the baby IS Cw+, the chances that the antibody will do any harm are very small indeed. Your doctor/midwife should just be aware of it when they do the normal ante-natal tests. In the unlikely event that you yourself should need a blood transfusion at any time during your life, you should also mention it, so that the lab can make sure you receive blood that is Cw- (doesn't have the Cw antigen) - not difficult as 98% of blood will NOT have the antigen. The lab always checks before transfusing, but sometimes the antibodies disappear over time.

I hope this puts your mind at rest. Enjoy your pregnancy. Best wishes

Anna

Thank you Anna, that was really well put, i understood it easily, thanks. yeah I'll try not to worry, i think my mind is just in overtime mainly because the doctor didn't tell me anything.

There is more to blood than i thought, you all have very interesting jobs, i thank you for your intellegence and overcoming confusion for people like me to ask you questions!!

:-D

bianca

bianca - You are a pretty smart cookie, too, to find this website in pursuit of explanations to your questions & concerns. It would be great if you could keep us posted on your progress and let us know how things are once your baby is born. Anna's right.....relax and don't worry!

Kudos to Anna for that great response!

Hi Bianca,

I agree that Anna's response was brilliant.

DO NOT WORRY about the anti-Cw (or anything else come to that).

As you have never had a transfusion and this is your first pregnancy, the chances of the anti-Cw being clinically significant to either you or your unborn baby are as near nil as could ever be. Your hospital is "covered" by the NHSBT-Tooting Centre and, if your hospital thinks it worthwhile, we will monitor the antibody during your pregnancy, but it depends on the titre (strength of the antibody) in your plasma. I am prepared to be my mortgage (even after yesterday's budget!) that your anti-Cw is extremely weak, and we would not even bother monitoring it after 28 weeks gestation, and would certainly NOT advocate testing your partner's blood.

If you can convince your obstetrician that this should be done (and, if would give you total peace of mind, go for it) we would gladly perform the test, but it really isn't a worry. IF, AS YOU SAY, YOU HAVE NEVER BEEN TRANSFUSED OR BEEN PREGNANT BEFORE, THIS ANTIBODY WILL CAUSE NO PROBLEMS WHATSOEVER.

Indeed, most cells used to screen for antibodies in the UK are NOT Cw+, so confident are we that the antibody is clinically insignificant in cases such as yours.

Edited April 24, 200916 yr by Malcolm Needs
Checking Bianca's post before making a fool of myself!