The Great Unknown

We have recently learned that this is now considered a high risk pregnancy, although at this moment we don't know to what extent.

Last Thursday I got a phone call from my doctor saying that my blood work came back positive for the anti-c antibody. I have not had this in previous pregnancies and while her original thoughts were it happened during my delivery with Jack, it's looking more like it's happened within this pregnancy, since it was negative at my 10 week blood work up. Basically, I must have had a silent bleed at some point in this pregnancy and the baby and I have shared blood, changing the make up of my blood and my body is now attacking the baby's red blood cells. While I understand much more than I did last week, I still don't completely understand the genetics of all of it. What this could result in is severe jaundice in the baby either before and/or after birth.

Last week my titer levels (what they judge this by) came back at 1:1, which is very good news. I retested again this past Monday and my levels remained at 1:1, which is great news. It means the levels are very low and that my body has not yet started viewing the baby as "foreign". If it starts to rise, it means my body is going on "attack" mode. I will retest again every two weeks until the end of the pregnancy and we will base the next course of treatment on those results.

The outcome for this can vary. Worse case scenario, which we are not allowing ourselves to go to, would be stillbirth. Best case scenario is that my titer levels remain low and I go on to have an semi-uneventful remainder of the pregnancy and normal delivery. Other possible scenarios include a preterm delivery and possible NICU stay, interutarine blood transfusions and/or blood transfusions after birth for the baby, and mild to severe jaundice (which in it's own right could require a NICU stay regardless of being term or not). Long term (after the newborn period) there should be no risk to the baby. Long term for me - if I were to ever need a blood transfusion in the future, I would need to make sure they gave me some that has this anti-c antibody or my body will reject it. It may make sense for me to bank my own blood when I'm not pregnant, but we'll cross that at a later date.

Although my titer levels could raise at anytime, it is to my benefit that they are so low and that it happened so late in the pregnancy. Titer levels raise in doubles, so 1:1, 1:2, 1:4, etc, although could jump mulitple levels. As long as my levels remain under 1:8, we can continue on as though this was a normal pregnancy, minus the extra blood work. If it raises beyond that, we will go to the next step which are specialized ultrasounds that would check the baby for anemia. It's only if those results are too high, that we would start discussing the interuterarine blood transfusions. The belief is if my levels remain as low as they are now, that the baby should not have any complications (in regards to this) at birth, although we won't know that for sure until he/she is born. For right now, I am able to stay with my doctor, who is consulting with a high risk doctor. If things get worse, I will be referred to a perinatoligist at a larger hospital.

So for now, we sit and wait. I'll admit it's weird to be "high risk" and yet have nothing I can do change the outcome of this. My next test results will be in 2 weeks. When we got this news we were devasted as I'm sure you can imagine, but now we are cautiously optomistic about it. Right now, we could really use your good thoughts and prayers that my titer levels stay low and that this remains an uneventful pregnancy with a normal delivery.