are we having fun yet?: Pregnancy and Blood Antibodies: otherwise known as KIDD or JKa

I always wanted four kids. Justan wanted one. So we compromised.......and we are having our fourth and FINAL baby due May 4, 2013. For those of you doing the math, Kendall and this baby will be about 11-12 months apart!!!

As of today, I am 17 weeks and 3 days. Tomorrow we are going in for the anatomy ultrasound and we will find out if this baby will be a boy or a girl!

As if I weren't shocked enough to find out we were pregnant again, I was even more shocked to hear I tested postive for the KIDD or JKa antibody. Thank goodness, I've always had the most boring, run of the mill pregnancies. Of course, the doctor calls and tells me this over the phone, so while I'm listening, all I hear is "blah, blah, blah" and I hope to learn more about it later. They want Justan to come in right away and have his blood tested. So, the next day, Justan walks into my OB's office and says to the front desk, "I'm here to have a pregnancy test!" They said, "your wife already warned us about your shennagins!" A few days later, they called and said that Justan tested positive for the antigen (the opposite of the antibody).

What I have since learned, is that because I did not test positive for this when I was pregnant with Kendall and I have never had a blood transfusion, they believe that the antibodies in my blood probably came from Kendall's blood mixing with mine during her delivery.

Justan must have passed to Kendall a blood component that was "normal" in him, but "foreign" to my body. When Kendall's blood somehow mixed with mine, it made my body think that it should build a defense against this component just in case it should ever encounter this particular creature again.

Now that I was pregnant again, those antibodies became an issue as they could potentially recognize this foreign blood in the baby that I was carrying, and attack.

Eventually this could result in hemolytic disease of the newborn. My Jka antibodies, which target antigens in the Kidd blood group, can travel across the placenta and attack the fetus's red blood cells if it happens to be carrying components of the Kidd blood group. Over time, this can result in severe anemia and ultimately multi-organ failure in the baby. The good news was that if the baby could be born without my antibodies attacking, meaning the baby was not carrying the antigens, then there was no further risk to the child. This was strictly a problem in utero.

Originally, when the doctor called, I thought they had said I was RH positive. When I Google'd about it, I learned there was some sort of shot, that was able to help women who were dealing with that. But this antibody is not the same. I asked my OB and she told us that there was nothing we could do about these antibodies except undergo regular blood tests to monitor my titer levels. As long as they stayed low, then all was well. Should my antibody levels start to rise, then that would be an indicator that the baby carried the offensive antigens. If that happened, my OB would conduct further blood tests to confirm fetal anemia and in the worst-case scenario, the baby would have to undergo an intrauterine blood transfusion or would undergo transfusions in the newborn period.

At every appointment, I surrender a vial of blood and wait for the nurse to call me with the news. This process takes about 3-4 days. They are unable to start the intrauterine blood transfusions until the baby is at least 16 weeks anyways, but I've given a ton of blood so far. And so far, my titer levels have remained low.

I will continue to hope my titer levels remain low and not to have to do the intrauterine blood transfusion. In addition to my regular OB, I also see a perinatologist (a high-risk OB). As long as the levels remian low, I now just have to give blood once every 2 weeks. If they go higher, I will have to go in 1-2x a week. My high risk OB said that this antibody is very rare and they only treated 3 people in all of Atlanta last year (at their practice, of course). I'll be honest. That freaked me out.