Tue Sep 11, 07:24:00 AM 2007 beegley101 said... I have been typed by the Red Cross as a volunteer blood donor as O+. I am now 21 weeks pregnant and have been typed twice by my OB's office and the results are calling me O-. My OB says I'm probably 'weak D.' I'm worried about taking Rhogam. What happens if an Rh-positive patient gets Rhogam?
Kenneth F. Trofatter, Jr., MD, PhD said... To beegley101 Sept 11: If the Red Cross has typed you as O-positive, and your doctor's office laboratory has not, I would go with the Red Cross. They are about as good as one can get in the blood-typing arena! Your doctor is probably correct - you likely have the Du-variant of Rh, sometimes referred to as the 'weak' Rh D-antigen, and technically this makes you Rh-positive. Du-positive women cannot become sensitized to the D-antigen. Therefore, Du-positive women do NOT need Rh-immune globulin (Rhogam) during their pregnancies. If you got it inadvertantly, it would probably not cause any harm to the baby, but you just don't need it. But, your doctor needs to get this sorted out once and for all, even if he/she has to send you to a hematologist to do so, althoough usually it is simply a matter of notifying the laboratory that there has been a discrpeancy in blood-typing and they need to screen for the Du-variant. This was a great question that I have not addressed in any of my posts on this subject. Du is very common in Black women, so I am sure a lot of readers will be interested in my response to your question. Thanks for reading! Dr T
Tue Sep 11, 05:25:00 AM 2007 Anonymous said... I have 3 sons all of which I was induced at 37 weeks due to cholestasis. During all 3 pregnancies I also had gallstones, after my third baby I had my gallbladder removed. I am now 28 weeks pregnant with a girl and have no gallbladder, am I likely to get cholestasis in this pregnancy the same as the others? or should I be ok as i have no gallbladder/stones this time?
Kenneth F. Trofatter, Jr., MD, PhD said... To Anonymous Sept 11: True cholestasis of pregnancy is linked to genetic polymorphisms involved in bile acid metabolism in the LIVER, not the gall bladder. Think of the gallbladder as simply a storage sac for certain digestive enzymes produced in the liver and released when fatty foods are present in the digestive tract. So, true pregnancy cholestasis will probably NOT be improved by removal of the gallbladder. However, if your cholestasis was related to obstruction of the bile duct by gallstones (causing bile acids to back up into the liver), not by an enzymatic defect in the liver, then you just might do better this pregnancy. But, having your gallbladder removed is a heckuva way to confirm the diagnosis of true pregnancy cholestasis! Hope you don't itch this pregnancy. Thanks for reading and for a great question! Dr T