I suppose I should feel encouraged, but I really don’t. I think it’s their job to put your mind at ease, and try to pull you away from worst-case scenarios.
I have a low level of the antibodies (forget the official name), but they’re “the lowest they can be,” and apparently they “deal with patients like this all the time.” Great – there are stillbirths dealt with all the time as well, and somehow that doesn’t paint a rosy picture. There doesn’t seem to be a clear-cut reason why I’ve developed this; it sounds like there are rare cases when a woman can become sensitized between first finding out she’s pregnant and week 28, when the shot of Rhogamm is routinely admitted. So there wouldn’t necessarily be any reason to keep testing; they question is, did my doctor(s) perform an initial test? I’ll be asking that next week at my apt.
Sure enough, when I inquired about my baby getting sick and some of the outcomes I’d read about, my doctor said, “I think you’re looking at extreme cases.” Okay then, what should I expect? They’re going to keep monitoring me every month, and if the levels get past a certain point – there’s nothing I can do, they’ll decide on their own, damn bastards – I have to see a specialist (think amnio, possible inductions, etc). Sounds like this part of the article I linked in my last entry:
Your practitioner can monitor your levels of antibodies and keep tabs on your baby’s condition during the pregnancy to see whether he’s developing the disease. She may check on the condition of your baby’s red blood cells using Doppler ultrasound or amniocentesis.
I asked what I should expect if I continue at the same levels, if I should anticipate anything bad, and she said “I wouldn’t” or something to that effect. I think she was trying to tell me not to get ahead of myself – but what do I know? I can’t help but worry, especially when I read this next part:
If he’s doing well, you might (emphasis, mine) be able to carry him to term without complications. After birth, he may be given an “exchange transfusion” to replace his diseased Rh-positive red blood cells with healthy Rh-negative cells. This stabilizes the level of red blood cells and minimizes further damage by antibodies circulating in his bloodstream. Over time these Rh-negative blood cells will die off and all your baby’s red blood cells will be Rh-positive again, but by that time, the attacking antibodies will be gone.
I believe this is an extreme case, but could possibly be a next step:
If your baby’s in distress, he might be delivered early or given transfusions through the umbilical cord. The survival rate for babies who receive a transfusion while in utero is as high as 80 to 100 percent, unless they have hydrops (a complication caused by severe anemia), in which case the chances of survival are about 40 to 70 percent.
Needless to say, I’m rather discouraged, and even though she didn’t seem to think it was serious – “these things happen all the time!” – I can’t help but worry about it. And I’m further distressed when I read this:
Once you’re sensitized, you have the antibodies forever. And you produce more with each pregnancy, so the risk of Rh disease is worse for each subsequent baby.
Does that mean I shouldn’t have more kids? And what would I do – get my tubes tied or take BC till I go through menopause? I don’t understand… I feel rather lost.