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Re: anti-little-c? will it hurt the baby?From: Christine (anonymous@obgyn.net)Mon, 1 Nov 1999 11:49:55 -0600 (CST)
At Sun, 31 Oct 1999, Bryce wrote: > >my wife is pregnant, about 2 months along. Just recently she visited >her Dr. for a routine exam. He informed her that he would need all the >files about her pregnancy w/my 19 month old daughter because the blood >test showed something he called "anti-little-c", which he said is fatal >to the fetus in 9 out of 10 cases. He also said that if it was present >during her last pregancy, then she probally did not have to worry. The >Dr. also left on vacation and won't be back for a week and I am going >nuts, i need to know about this "anti-little-c" thing, or at least where >I can find some info. A little info that may help, I am blood type AB+ >and my wife is o+. When Staci was born they said she had a high >"Billy-ruben" count. We were told that was because her body was >fighting it's own blood because of our two different types. Does any of >this make any sense? Is it all related? Please help me understand this. > Thank you for your time, > Bryce > >-- >Bryce Riha >CarDr21@AOL.COM Hi Bryce: If you are type AB and your wife is type O, you can only have children either type A or type O. (not AB or O) When this happens, the O mother's antibodies against A or B can cause what is known as "ABO Incompatibility" in the baby. These antibodies attack the baby's red cells (where the corresponding antigens are located) and the byproducts of this causes an increase in bilirubin in the blood. The baby's skin turns a yellowish hue and he/she is put under the lights. Elevated bilirubin can cause problems but usually only when very high, which is why they stay on top of the situation with bili levels in the baby, and the lights. In extreme cases an exchange transfusion can be done, but I don't think this happens very often with ABO incompatibility. Your first baby's increased bilirubin was probably due to this ABO incompatibility. "Little c" is part of the RH system, which is different than the ABO system. The most serious form of RH incompatibility is the formation of Anti-D (a part of the RH system) in the RH negative mother. This is what happened years ago and can now be prevented with products like Rhogam. Unless they have come up with something new in the 20 years I have been out of the field, there is no similar preventative product for the other parts of the RH system. In the past,they didn't usually test for antibodies in the RH postive mother unless there was reason to suspect a problem. I am curious-are they now testing all mothers for antibodies? They will follow your wife with antibody titers (levels)periodically throughout her pregnancy. They can tell how serious the problem is by the rise in titer. With good prenatal care, I don't think it is true that this problem is fatal in 9 cases out of 10! Your wife would have the little c antibody in her last pregnancy if she had once had a blood transfusion, miscarriage, or previous pregnancy. (and the transfused blood or fetus had the little c factor) She won't have a problem with this pregnancy unless this baby has the little c factor(previous exposure to this is what made the little c antibody in your wife)inherited from you. According to the book I am looking at, 18-20% of the U.S. population does not carry the little c factor. This second baby would have inherited the big C factor from your wife (she can't have the little c factor since she made little c antibody) and perhaps from you also, in which case there would be no problem. If the second baby inherited the little c factor from you, with good prenatal care, things should go okay also. Hope this helps. Chris S.
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