If you think you may be at risk of hemolytic disease of the fetus and newborn (HDFN), regular antibodyAntibody A protein made by the immune system that recognizes and attacks foreign substances, such as bacteria, or in HDFN, fetal red blood cells carrying incompatible antigens. tests can identify if maternal antibodiesAntibody A protein made by the immune system that recognizes and attacks foreign substances, such as bacteria, or in HDFN, fetal red blood cells carrying incompatible antigens. have developed.
The first antibody testAntibody test A blood test performed during pregnancy to look for antibodies that could affect a developing fetus. usually takes place at eight to 12 weeks of pregnancy, and the waiting period can be anxiety-inducing. To help, here are some techniques you can use to manage the wait.
What is HDFN?
Hemolytic disease of the fetus and newborn (HDFN) is an immune-mediated red blood cell disorder that occurs when a baby’s RBCs break down quickly, which is called hemolysis. HDFN is caused by a mismatch between a mother’s and her baby’s blood type (A, B, AB, or O) or Rhesus (RhRh factor A protein or antigen found on red blood cells. When an Rh-negative mother carries an Rh-positive fetus, her immune system may make antibodies that attack the fetus' red blood cells.) factor (Rh-positiveRh-Positive A blood type trait that means your red blood cells have the Rh(D) antigen. or Rh-negativeRh-Negative A blood type trait that means your red blood cells lack the Rh(D) antigen.) during pregnancy.
The first antibody test
An infant is at risk of developing HDFN if they have a blood type incompatibility with their mother, most commonly Rh incompatibility. If the mother becomes alloimmunized, she develops antibodies that cross the placenta and attack the fetus’s red blood cells.
HDFN occurs less often in first pregnancies, but once a pregnancy has been affected, subsequent pregnancies will be at greater risk of developing HDFN.
Learn more about HDFN testing and diagnosis
The first antibody test is an important step in assessing the risk to the fetus and the treatment required. It usually takes place at 8 to 12 weeks of pregnancy and will check for antibodies and if they are present, another test called an antibody titer will likely be ordered.
If no antibodies are found, the test will likely be repeated at 25 weeks’ gestation.
Tips for managing the wait
Anxiety, stress and a feeling of powerlessness are common emotional reactions to waiting for medical tests. Uncertainty about the next steps and the health of your baby can make it hard to concentrate on anything else.
Here are some techniques you can try to help you manage the wait for your first antibody test:
Avoid online research: ask your healthcare team for information, advice and support instead of going down the internet rabbit hole.
Focus on the here and now: speculating or hypothesizing will only worsen your anxiety.
Ask for support: Share your concerns and emotional state with close family and friends, and consider speaking to a therapist.
Manage intrusive thoughts: meditation, deep breathing, relaxation and mindfulness apps can be very helpful in calming your thoughts and anxiety.
Get enough quality sleep: Sleep is important for your overall health and well-being, giving you more energy to cope with a stressful situation.
Stay optimistic: a positive attitude can help ease an anxious mind.
Managing your emotions will also benefit your baby’s well-being as stress hormones can cross the placenta and affect the baby’s development.
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