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Old 01-31-2009, 10:38 AM   #1
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Antibody/Antigen E anyone?

Hi mamas. Has anybody ever experienced developing E antibody in your second pregnancy? Apparently I was exposed to the E antigen when I was prego with DD, and now my body has developed an antibody for it (a potential complication with LO #2). From what I understand, it's a similar concept to the whole Rh +/- thing, except that it can't be treated medicinally.

Anybody have insight on this?
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Old 02-01-2009, 10:55 AM   #2
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Re: Antibody/Antigen E anyone?

I have the same thing. This is pregnancy #6 for me, and it just showed up this time. I have my blood drawn once a month to check on my titer. My doctor said as long as it stays below 1:16, we are considered safe. If it goes up, then I will be referred to a high risk ob. I've seen the high risk ob already for my genetic testing (over 35 yrs) and mentioned the issue. He said that if my titer rises, he will want to do more ultrasounds to check for signs of anemia in the baby. This condition is just as dangerous as being rh neg because E is connected to D (which is what rh is called in the blood bank). FYI it is also connected to C. (I spent many years as a blood banker)

I looked at a study done at a university hospital (I don't currently have that link), but the outcome for babies born to mom's with AntiE with the proper surveillance is very favorable. Even if the titer goes up, the worst case scenario would be in utero transfusions or early delivery. Either way, the odds are great that our babies will survive (and thrive!).
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Old 02-01-2009, 11:00 AM   #3
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Re: Antibody/Antigen E anyone?

I had antibody m, the Dr's were not concerned about it at all. Not sure what the difference between e and m is.
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Old 02-02-2009, 09:42 AM   #4
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Re: Antibody/Antigen E anyone?

Hi there!
I was Anti-E and Anti-Kell in my last pregnancy. It was closely monitored thru my pregnancy (monthly blood draws to check levels and sonos at the MFM office.) My dd was born naturally without any complications at 38 wks. They tested her at birth and she was not E or Kell positive, so that's why it went so well. My husband's blood was tested when we found out I was Anti-E and Anti-Kell and he is hetrozygotic E & Kell positive (means that 50% of his cells have it, so we had a 50/50 chance of the baby having it.) Had the baby been positive as well, the risks would of been much higher.

I blogged about my pregnancy (see siggie) and you can do a search for isoimmunity if you want to read about our experience.

There is another DS mama that had the same condition as me, but her levels got really high and they had to do in-utero transfusions & early delivery, plus blood transfusions after birth. Her dd is gorgeous and healthy now. She also blogs: Me? A Mom? I learned a lot about isoimmunity from Cara.

Hope your levels stay low and you have a healthy pregnancy.
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Old 02-15-2012, 09:20 AM   #5
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Re: Antibody/Antigen E anyone?

Bumping this since I just got diagnosed with the same thing. Anyone else dealt with this? Outcomes?
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Old 02-15-2012, 09:52 AM   #6
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Re: Antibody/Antigen E anyone?

I found out in the delivery room with my ds that I was sensitized. Anyone who says you cant get rh sensitized during a normal pregnancy with no trauma or bleeds is wrong, lol.

His billi level was almost 22, and one of the things we think he might have is BIND, bilirubin induced neurological dysfunction. He shows a lot of the signs, being uncoordinated, autism like behavior, undeveloped teeth, and so on. But who knows? It's all just guesswork at this point.

Dh is heterozygous for E, so we have a 50/50 chance. Youngest dd is ee, so my pregnancy with her was pretty normal and her billi never got over 13.

We've been doing a lot of research, and it seems like its one of those things that sometimes doesn't cause any problems, and sometimes causes major problems. They had a baby born last year at dh's hospital with anti E and he spent a lot of time in the NICU and got some exchange transfusions, and was delivered early. But then the literature doesn't show that its a given that will happen. It's kind of rare, so there's not a lot of info on it. From what I understand, an E rh factor often goes with a C rh factor, and e often goes with c, so if you are anti E, you often become anti C as well. So get checked for that.

During pregnancy they will draw your titers, and they will also do u/s for the middle cerebral artery pressure fairly often. Increased pressure is bad. Rising titers are bad, too. In utero they can do exchange transfusions, but those carry pretty significant risks. But, then again, hemolytic disease of the newborn isn't a cake walk, either.

So, I guess the take home is, you will get monitored closely, hopefully there will be no problems, but if there are, they have things they can do. This is not the type of pregnancy where you can thumb your nose at OB's and tests and go on your merry way. You really need close monitoring (general you, BTW, I'm not saying you would do that). You will probably have to stay at the hospital longer to keep a super close eye on your baby's billi levels. We usually leave early IF the baby's levels are looking good at 24 hours of life, but I also have a husband whose a Pediatric specialist, and we have awesome followup, which we take advantage of. We absolutely go in every day for heel sticks. Without fail. This is absolutely crucial. I can't emphasize that enough. With ds we left at 24 hours old in the afternoon and he had a billi of 6. The next morning he was 22. It can rise very fast.
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Old 02-15-2012, 10:10 AM   #7
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Thanks for the info. I've had a hard time finding much other than articles out of medical journals, which are not too helpful for me!
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Old 02-16-2012, 05:33 AM   #8
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Re: Antibody/Antigen E anyone?

There's really not much info out there, so I hear you. Dh is a neonatology fellow, and he's been looking for info, he's talked to the staff, he's talked to the MFM's, and everyone is all They know how to monitor for it, and what to do based on certain results, but no one knows what the odds are of things going OK or not going OK. So, they just follow the standard of care, and then deal with what they get. I feel very lucky that dd had ee, and didn't have any problems, and so my pregnancy with her was pretty typical. I mean, as typical as a pregnancy for me can be, lol, I've had a few losses, premature birth, blood clotting disorder, and this antibody thing. But she was born full term when she wanted to be, she was healthy, and she didn't even needs lights! My older 2 were orange as pumpkins, lol.
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