Monday 24 November 2008

Booking In With The Midwife

I had an appointment today with the midwife. Nik and Max came with me too. It took ages to give her all my relevent medical history and i came away with a pile of pregnancy literature and some coupons for free stuff too! I asked the midwife about Anti-E and what she told us still seemed a little vague, she has sent off my blood and said we'll decide what to do when the results come back (depending on the level of Anti-E in my blood) i'll tackle it again with her then. I did give her a print out of the information that Melissa (the lady in USA) gave me on Anti-E. Maybe that will get her interested a bit more about it. I'm definately not gonna just forget about it until the birth because thats what she was trying to tell me (i think) this needs constant blood monitoring every 2 -4 weeks to check the levels in my blood aren't rising and then after i'm 24 weeks i need to be scanned regularly to make sure 'Peanut' is ok in there. I'm sure they'll get sick of me but i'm gonna nag them to death!

Sunday 23 November 2008

Information on Anti-E

I forgot to post this the other day. Its from a lovley lady who also had Anti-E and she sent me an email telling the story of her pregnancy/birth experience.

First and foremost, if this is your first pregnancy please know that things tend to go VERY NORMAL with NO COMPLICATIONS during your first effected pregnancy; we were told the chance of anything happening with a first effected pregnancy is less than 1%. However, with each effected pregnancy the risk of complication dramatically increases. However, there is no guarantee there will or will not be any problems with any pregnancy. Once you have one effected pregnancy your second is not guaranteed to be affected. You could go on to have several children with the same father and never have another effected pregnancy---it all depends on who’s blood composition the baby receives. Also, before I get too involved with this, I want to make this clear, I am not a doctor by any stretch of the imagination nor do I claim to be or understand everything they tell me. My medical knowledge/lingo is very limited so I ask them to tell me in "laymen’s terms" and that's how I explain it to other parents.

How do they test? What are they looking for?

In the beginning of your pregnancy they take an initial blood work up and that's how they discover the anti-e or E. What they will do is monitor your titer levels until you are around 24 weeks then they can really begin to monitor the baby through ultrasounds called MCA Dopplers. What they are looking for are signs of the baby becoming anemic. If this happens to the baby in utero it's similar to an adult having heart failure. I don't want to scare you but that's what this all boils down to and that's what they are looking for.

What are titer levels? What do they mean?

This is measured in "titer levels" and they are read as ratios (and each time they increase they double)...for example: 1:1 then 1:2 then 1:4 then 1:8 then 1:16 then 1:32 then 1:64 then 1:168 and so on. I've been told they don't start to monitor you and baby very closely until you are at 1:16 or 1:32 (depending on the doc). Mine started at 1:16 with the initial blood work up and in three weeks were up to 1:64. Titer levels do not guarantee or tell how a baby is doing; it’s just a standard they use to determine how closely they need to watch/monitor the mother and baby. With my experience once I got to the 24 week mark they never tested my titers again because they were using the MCA ultrasounds (this monitors the amount of blood flow to and from the baby’s brain) and they will also check the fluid levels in and around the abdomen and brain. The MCA Doppler U/S is a more reliable test than the titer levels. However, I have corresponded with women that did have their titer levels monitored while also having the U/S.

Does blood type (letter) matter?

Blood type does not matter, neither does race nor gender. The blood type (A, B, O, etc) does not seem to make a difference with the antibodies (c, C, d, D, e, E, Kell, etc). My husband and I are both A+, our first son is A+ (unaffected pregnancy) and our second son (first affected) is O+. The antibody is part of the blood composition not (letter) type, from what I’ve been told.

How do you get it?

The most common way to get this antibody is through a blood transfusion, if you have never had one then it came from the father of the baby—a blood transfusion just not in the ‘conventional’ way. (Same situation I had) This is not guaranteed to be a concern with every pregnancy. I have a 5yr old son (same father as Cameron---the baby I’m referring to) and we never knew anything about anti-e. My initial blood work never showed any signs of it (not that we knew to look for it but it’s a routine check with your initial blood work when you are pregnant). My husband also has an 12 year old daughter from a previous marriage and they never had any problems with this either. However, I have been told that now that I have the antibody it will stay with me forever. There are no adverse effects of having the antibody (for the mother) once the baby is born. If you are aware of the antibody and are not under a doctor’s care during pregnancy the mother could be harmed if the baby develops problems while in-utero.


Fetal Anatomic Ultrasound—what is it?

At approx 16 weeks they will most likely do a Fetal Anatomic Ultrasound---it's much more than just 'taking a look and finding out the sex' of the baby. We saw everything from the top of his head to his toes---to include organs, spine, little flap that is over your spine (I forget what it's called----again I'm no doc!). It was amazing and it took just over an hour for the ultrasound. What they are looking for at that point is to make sure the baby is developing "on schedule."

What happens if the baby becomes anemic while in-utero?

By now you may be asking yourself what happens if the baby develops anemia....If they determine the baby is developing anemia then they do an inter-utero blood transfusion (IUBT). They will do an IUBT up until 34 weeks (some docs won’t do one past 32 weeks but most will go as long as possible because of course the longer the baby has to develop on the inside the better)....if the baby develops anemia at 34 weeks or later they will take the baby (via c-section the majority of the time, depending on how far along you are, I suppose) and then do the transfusion. I was told the IUBT takes several hours. They will give the baby medicine to 'calm him down' make sure he responds okay to that, and then they begin the transfusion through the umbilical cord. Once the transfusion is complete you remain there for observation---depending on how you and baby are doing this can be a few hours to overnight.

My personal experience with an IUBT – we found out on a Tuesday that we had to have the procedure on Wednesday. That was the scariest time---the waiting. I was 31 ½ weeks at the time of the IUBT and they told me the would not do another one, if the baby continued to show signs of anemia after this IUBT they would do a c-section then do transfusions once the baby is born. They will do the early prep for a c-section before the procedure (just with giving you medicine) incase they need to an emergency c-section. Your spouse is not allowed in the OR with you for an IUBT but if they have to do an ER C-section they will try to get your husband for you. You are awake for the IUBT (most of the time). However I was not awake. They will do an amnio first to determine how anemic the baby is and how much blood the baby will need. That will determine how long the procedure actually takes. Ours took 45 minutes. Then we were monitored for 5 hours (it’s usually 4 hours) and sent home. We had to stay a little longer because I was having BH contractions and they weren’t stopping or slowing down---eventually they did and we went home. During the recovery/monitoring period after the procedure they will give the mother betamethodone (depending on how far along she is) the drug to help develop the baby’s lungs just incase they do need to take the baby early (before 35 weeks)---they are just being cautious and don’t want to take any chances.

What can happen once the baby is born?

This is the part that was the worst for us. At EACH and EVERY appt with our MFM we asked “what will happen once the baby is born?” and we were given the same answer each time “nothing, he will be fine once he’s born there are no complications to worry about.” That’s not always true. The most common effect once the baby is born is that the baby is jaundice. This is treated by either using a biliblanket, phototherapy or a combination of both. If the baby’s jaundice level reaches 25 it can begin to cause brain damage.

The other effect is a low hemoglobin and not producing their own red blood cells. The treatment for that is either IVIG (an immoglubin giving through an IV), a transfusion (sometimes referred to as a ‘top-off’ transfusion) or an exchange transfusion (in this procedure they replace all of the baby’s blood). My son has had several transfusions since birth and each one has taken 4 – 6 hours. Thankfully he did not need an exchange transfusion. Doctor’s do not like to do them because they are very risky---you are replacing a baby’s entire blood supply. That procedure is very lengthy as they remove some of the baby’s blood and put new blood in. This process is repeated until they have replaced all of the baby’s blood.
This is not to say all baby’s will have either of the above mentioned situations but it is possible. Again first effected pregnancy’s tend to go very normally.

Our experience (after my son was born) was the following: Our son was born on Monday July 24, 2006 at Duke University Medical Center and was in the NICU for 36 hours then moved to a special care nursery for 24 hours then moved into a room of his own on the pediatric floor for 3 ½ days—where we were able to stay with him. He was having problems with jaundice and a low hemoglobin. They gave him a dose of IVIG for the hemoglobin and had him on the biliblanket and 4 phototherapy lights. They released him on Saturday July 29 with a bili level (how they measure jaundice) of 14 which was too high. On Monday July 31 we had an appt with his pediatrician and he was immediately sent back to the hospital (thankfully a different hospital, Wake Medical Hospital) as his jaundice level had reached 22.5 and his hemoglobin was 6.8 (low). He was there until Saturday August 5. As soon as we got there they were ready and waiting for us----they had his incubator set up with a biliblanket and 5 phototherapy lights. He was also treated with another round of IVIG and blood transfusions throughout the week. His bili level came down quite quickly at first and then seemed to plateau at 13 but eventually went down to 8 and that’s when we were able to go home on Saturday around lunchtime. His hemoglobin was a like a rollercoaster between 6.5 and 8.5.

Once we left that hospital we followed up with his pediatrician and a pediatric hematologist/oncologist, through University of North Carolina at Chapel Hill Hospital (the specialties go together, don’t get scared that cancer is a possible side effect of anti-e or E----it’s just that blood and cancer go together). We had daily blood tests for a while then down to three times a week, then two times a week then weekly and they slowly tapered off. As of Sept 29 he finally tested negative for the antibody and for the first time showed signs that he was ‘reticing’ (making his own red blood cells). During our time from Aug 5 through Sept 29 he had several more transfusions. But he is okay now----as your baby will be too.



My goal is let other mothers and fathers know they aren’t the only one with this; they aren’t the first one to go through this. I am just trying to pass along the info I learned throughout my pregnancy and once my son was born. When we were first told about this antibody we didn’t have a clue and as you know by now, the info on the internet is very little. If you have any other questions/concerns/comments or just need to get some frustration out---I’m here. Please don’t ever feel alone while you are going through this.

Told Everyone Today

I have been feeling a bit better over the last two days. I still feel sick but its not as bad and i have been able to cook a bit of food.

Today we decided to tell everyone. We started with, dad, then they boys, my mum and my bestest friend (Vanda). Eveyone got a shock at first and then excitement followed LOL

I have my first appointment with my local midwife tomorrow so, i'll be asking again about some information about Anti-E but i'm not very hopeful. I will update tomorrow if i find anything interesting out.

Friday 21 November 2008

Second Scan



I went for my second scan today. The baby is now the size of a peanut or a kidney bean LOL. Eveything was fine and the baby had a good strong heartbeat.

I asked about anti-E and a midwife said she would get me some information to take home to read but at the end of the appointment when i went back to see her she hadn't been able to find a thing! She promises me that she will contact Jane my local midwife and get her to get me something. Still don't think i'm any closer to finding out what i need to know. I have an appointment on Monday with the midwife at the health centre. Hopefully i will get my answers then.

Tuesday 18 November 2008

Feeling Rough

I haven't blogged for a while because i have been feeling so ill with this baby. Never ever felt this bad before when i was pregnant. I can't sleep, my boobs are killing, i have zero energy and i feel sick all day long. The best part of the day is from around 8-9pm when i can just sit still and take my mind of it by watching tv. I'm a Celebrity has just started and i love to watch that but when they were eating the bugs and grubs last night it didn't help me much euwwwwww

Nik is doing tons of stuff to help me but i just lack energy. My get up and go has got up and gone. Its a nightmare trying to eat anything. There is nothing i fancy and i have completely gone off sweet things and chocolate too!

I have my second scan on friday and i can't wait to see how much the baby has grown. I might have to tell everyone about the baby soon because i can't hide how ill i feel much longer and i feel really bad about hiding it from everyone. ts just that I wanted to find out if the baby was ok first and learn more about the anti-E and the effects it will have on the baby.

Will be back on Friday to update after my scan :O)

Friday 14 November 2008

Gender Predictors

Last night i was fooling around on different baby sites and i came across a gender predictor. Well i decided to have a go LOL I filled in my dob and Niks dob and the first day of my last period and it said..... A GIRL! PMSL but then i had a go on a few more and they said boy so i'm still no wiser. I don't really mind what sex the baby is as long as its healthy but i suppose a girl would be nice after 4 boys but then it'd probably be a tomboy anyway.

The sickness is still really bad, it eases it if i lie down but you can't spend all day horizontal (unless your Belle De Jour PMSL) so i keep trying but cake making has gone out the window and the house isn't as tidy as usual. I can't even get motivated to go shopping (yep, must be ill!)

My next scan is a week today, i'm really looking forward to seeing a heartbeat this time because the baby was so small last time that it only just showed up on the monitor. I think it always makes you feel better when you've seen everything is ok.

Gotta go and make tea now, but my sense of smell has gone into overdrive and the chicken smells disgusting! Nik has been fab helping me out though, so i mustn't complain.

Wednesday 12 November 2008

Feeling Sick



This what my baby should look like now (taken from web)

This week marks the beginning of the embryonic period which spans from the 6th to 10th weeks of pregnancy or the 4th or 8th weeks of fetal development. This period is crucial for your baby's organ development. Most malformations originate during this critical period. Although your baby's heart is no bigger than a poppy seed right now, it may be possible to see baby's heartbeat on an ultrasound screen; your baby's lungs have formed and the brain is beginning to develop. Over the next 5 months, more than 100 billion neurons will be formed in the brain, laying the necessary groundwork for a lifetime of learning. By the end of this week, your baby will be 2-4mm (0.08-0.16 in) long from crown to rump (distance from the top of the baby’s head to its rump or buttocks).


OMG! i feel so sick today. I was supposed to do the school run but when i got out of bed the sickness was so bad that i had to lie down on the sofa. I'm never actually sick but its just as bad. It lingers for so long and the only way i've found of making it less is if i eat a little bit of something, but the last thing you want to do when you feel sick is eat anything! Toast seems to be working or a cup of tea, drink of milk or ginger biscuit. Tomato soup in a mug tricks you into thinking its a drink so, thats a good one to have as well. It took some getting up from the sofa this morning but with a 2 year old wanting all of your attention, it had to be done. The thing is the minute you have a bit of food you start to feel a little better, it never actually goes away but an improvement is better than nothing.

I had my ECG yesterday and although the nurse that did it says she couldn't 'officially' tell me it was ok, it looked ok to her. I haven't heard anything from the doctors today so, i guess she was right.

Monday 10 November 2008

Palpitations Continued....

I went to the doctors this evening. She checked my blood pressure and listened to my heart with her stethescope and both were fine. So she has booked me in for an ECG tomorrow at 5.45pm. I will update tomorrow.

I have been feeling really sick today but it eases if i nibble on bits and bobs throughout the day. Large meals leave me feeling big and bloated and i struggle to digest them. I must remember to keep meals small but often. I really fancied some tomato soup today and ginger beer. I will have to put them on my shopping list tomorrow.

While i was at the doctors i asked for some information about anti e antibodies, but she didn't have a clue and hadn't heard about it. She kept asking me if i mean't anti d. OMG! If my own doctor doesn't know about it how am i gonna get any information about it or prepare myself. I found the following in a search tonight.....

Rh disease can occur if the mother is Rh negative and the baby is Rh positive. The mother can make antibodies against the baby's blood cells. These antibodies can cross the placenta and destroy the baby's blood cells making the baby very sick. There are many different Rh antibodies, but when we speak of Rh negative, we are referring the the D antibodies (most of the antibodies are named by letter).
A much less common form of Rh disease can be caused by E antibodies. That is a possibility in your case. Typically, though, the level of antibodies remains stable throughout the pregnancy, and there is no problem. Occasionally, the antibody level begins to rise indicating that it is possible that the baby is affected. In that case, the baby would be monitored with regular ultrasounds to be sure that he or she is still doing well. In the rare case that the baby develops anti-E Rh disease, it can be treated with a transfusion while it is still inside the uterus.


In the case of pregnancy Anti-E is rather common, so is
Anti-D; the Anti-D being formed when an Rh negative woman gives birth to an Rh positive baby and does not get Rhogam within the 72 hr. window. Anti-Lewis (Le(a+b-) may also form in pregnant women once in a blue moon, but not as prevelant as Anti-E. Since Anti-E can react either at 37C and/or IgG, so it needs to be watched. As a general rule, antibodies that react at IgG, are recessive in nature, or have the word Null or Rho in their descriptors, those need to be watched.

. "The rhesus gene is made up of three components, C, D, and E. Clinically significant rhesus problems usually only occur with the D antigen. However, if you are E antigen negative, carrying a baby who is E antigen positive and you come into contact with the E antigen positive (either from a bleed in pregnancy, at delivery, or from a transfusion), then you may develop E antibodies. The concern is that there is a risk of these antibodies attacking the red blood cells of the baby. In fact, the risk of this occurring with E antibodies, even when they are present in large amounts, is very low. However, when antibodies are present, blood tests are usually done regularly to check on the levels present. If these levels are rising, the baby would be closely monitored to look for any signs of anaemia or haemolysis (destruction of blood cells). I cannot give you exact figures as regards the possible risks associated with the presence of E antibodies, but I do know that some obstetricians do not even monitor the levels of E antibodies because they do not believe that these pose any risk to the baby."

Sunday 9 November 2008

Anti e antibodies and palpitations

I have had really bad palpitations today and at one point i felt really tired and cold. I'm going to call the doctors tomorrow and arrange to see a midwife.

I was doing some research on the internet last night about anti e antibodies and this is what i managed to find....(its a medical Q&A board)

Anti E

The antigens (the substance that caused you to form the antibodies) probably exist in your babies blood, and some of the babies' blood got into your system at delivery, which happens at all deliveries. This made you form the antibodies.
In your next preg, if the baby has the E antigen, your antibodies can cross the placenta and cause minor to major problems, even miscarriage and fetal death. The situation can be monitored, and sometimes intervention can be done.
Your husband's Rh phenotype, which tests him for E antigen, may be helpful, as it may tell whether all or only 1/2 of his children will get the antigen. In other words, it is possible that the next preg might be E antigen negative, and thus the antibodies, while present, will not attack the preg, as the offending antigen (E) isn't pregnant. This is worth a preconception planning visit to your doctor.

Friday 7 November 2008

My Scan Pictures

We went to the maternity unit today and i had a scan, Here are the photos.



The nurse that did the scan said i was 6 weeks, so the 3rd of November, here we come. I have a new scan appointment booked for 21 November when i should be 8 weeks. The scans should show a bit more detail instead of just a little blob :O)

We are still not telling anyone because its very early on and we want to wait a while. Its very hard not to tell though, especially today when my bestest friend rang me and asked when i was going for my MRI, i had to think fast and told her that they had cancelled it and it was rebooked for January. I felt really bad but i want to get used to it all first. I hope she understands when i tell her. I just have a lot to think about at the moment what with the baby and Jake etc..

Still feeling sick today and the muscles in my tummy and back have been hurting when i stretch or twist. I will have to be careful when i lift Max from now on. My body definately feels like its changing. We're off shopping tomorrow for some more tracky bottoms because i can't stand anything tight round my waist.

Oh the joys of pregnancy!

Thursday 6 November 2008

Morning sickness in the evening

The morning sickness has started to kick in but not in the morning but evening. Its making it really hard to cook tea when it all smells horrible and you don't fancy it :O(

My boobs have started to feel tender now and i'm feeling really fat at the moment. Its the scan tomorrow so i can't wait to see the baby (blob) and then maybe i'll start to believe that i really am pregnant. I am getting used to the idea now though, so things are not looking quite so bad :O)

Wednesday 5 November 2008

Been To The Doctors



This is how my baby will look now (taken from web)

The baby is now 1.25 millimeters long (0.05 in), roughly the size of an apple seed. By the end of this week, the beginnings of all your baby's major organ systems will be in place. Although miniscule, your baby's body is complex at this stage.

I went to the doctors today.

It was a really nice female one and i discussed all my problems. You can't have an MRI scan till you are over 12 weeks pregnant so the doctor has decided to send me for a dating scan on Friday at 12.10pm. This will tell us exactly how far gone i am so that i can get my MRI booked for when i am 12 weeks. So, hopefully that will sort everything out.

I am finally getting my head round it now, i think Nik is too because he's started making jokes about it. He said at least this time i'm pregnant we've got an upstairs toilet unlike when i was pregnant with Max. It drove me crazy getting up every half hour to wee in the night and then only managing the tiniest tiddle. Mind you, at the moment i can wee for England!

Hopefully this time will be better than the last cos i'm not working and lifting heavy stuff. I'm sure that was what caused the pains in my tummy which lead to me wearing that horrible velcro girdle from the hospital. I suppose we shall see.

Well thats about it for todays update. Bye for now.

Tuesday 4 November 2008

I'm Pregnant!!

I'm pregnant!!
Great news I hear you all say, well, maybe if this was a first, second or even third baby but this one is number FIVE!!! Now don't get me wrong i love children (i should do i have 4 already, either that or i'm totally mental) but this one has come as a bit of a shock. Its not a planned pregnancy (i'd like to call it a suprise rather than a mistake.... or maybe even a challenge) i was on the pill and i swear to God i only had s*x once this month!!!
Anyway, i snook out of the house yesterday afternoon on a mission to Tesco (or so i told my darling other half, cos i didn't wanna cause un-necessary panic) but i went to Lloyds pharmacy instead. I bought a test pack and popped into tesco to use their loo. OMG! was i shocked when the result came out positive. I came back home in floods of tears (having first booked an appointment to see my GP for Wednesday) poor fella didn't know what had hit him.
Now the pregnancy isn't the main reason of my panic. I was sent an appointment through the post last week for an MRI scan for the 10th November (I have a tumour behind my eye which the docs keep an 'eye' on and on my last visit they noticed a swelling on the side of my head so requested an MRI scan) and pregnant women can't have MRI scans till they are over 12 weeks pregnant!!! Arghhhhhhhhhhhhhh
The other problem i have is i have Anti E in my blood, this happened after my last child and i was given a card to carry and a letter saying that in future pregnancies the doctors will have to monitor me closely.
So here i am, worried confused, shocked, suprised and totally gobsmacked!
I thought i would make a blog as a way to get my feelings aired and try and get my head round whats happening, dunno if it will help me or even if anyone will read it but if you do or you are please leave me a friendly comment or a few words of encouragement cos that would be lovely :O)
I have a doctors appointment tomorrow at 11.40am so hopefully i can get my questions answered, will report back then............toodles for now.