# Anti-kell help pretty please?



## Goddess3_2005 (Oct 20, 2004)

I fond out that I may have this, my midwife is running one more test. I am having a hard time finding much about this . Could some one pretty please tell me what ever you know about this?

Another question too, is hydrocortisone ok during pregnancy? I'm taking it and I was told it was my my doc, but I am still unsure as its a class C. TIA!


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## channelofpeace (Jul 14, 2005)

I was diagnosed with anti-kell during my second pregnancy. It is hard to find information about it, but a lot of the same information applies with rh sensitization.

First, you'll probably need to find out how you got sensitized. If you have had a blood transfusion, that might be it. If you haven't had a blood transfusion, your mw (or doc) will test your dp. If your partner carries the antigen (mine did) they will further test to see if he is homozygous or heterozygous. If he is homozygous, all your children will have the antigen (kell) that you make the antibodies (anti-kell) for. My dh is heterozygous, which means that, statistically, our children have a 50/50 chance of having the antigen. All three have had it though, so so much for statistics.

There are a few routes you can take. If it is an issue with your dp being heterozygous, you can do an amnio to see if the baby does indeed have the antigen. You can also go the route of checking titer levels (above 1:32 warrants further observation) weekly sonograms to measure the blood flow through the cerebral artery in the brain. They can detect if the babe is getting anemic fairly well this way. If they babe is getting anemic (neither of mine were) they can do a blood transfusion through the umbilical cord. They can do this until the risks of the baby being born outweigh the risks of the baby staying in. My first sensitized baby was born at 40 weeks and my second we choose to induce at 37 weeks when it looked like him might be getting anemic.

After the baby is born, depending on whether they were already anemic in the womb will dictate what course of action. They watch for pathological jaundice (which is very different from normal physiological jaundice) The baby might need to be on bililights, have a blood transfusion or have ivig treatments.

*The good news* is that there is a ton of things that can be done about this. The outlook with the techonology available is amazing. And, some cases just aren't as severe as others. My first sensitized baby had to do the lights for three days and then we took him home with a biliblanket. He roomed-in with the lights and never went to the nicu. My second was extremely healthy and his bilirubin levels were never even enough to warrant lights. Sometimes the anti-bodies don't "see" the baby's antigen until late in the pregnancy and sometimes not at all.

I am sorry this is so long, please let me know if you need anymore information. I have a ton stored in my brain







Google Dr. Kenneth Moise. He has written stuff about kell


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## Goddess3_2005 (Oct 20, 2004)

Thanks for the help. So if I do have this what treatment do they do during pregnancy? Is it like the RH- where they give you a shot?


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## channelofpeace (Jul 14, 2005)

There is no shot for the anti-kell antibody. Once you have it, you have it, although whether or not it effects your pregnancy is dependent on 1) whether the baby has the antigen and if the baby does 2) if/how strongly the antibody reacts to the antigen.

RE: Treatment during pregnancy. Depending on if it is severe or not, they will monitor it with MCA Doppler (the sonos i referred to in my first post) to see if babe is getting anemic, and he/she is, they will do a blood transfusion/s through the umbilical cord.

Amniocentesis is not a great diagnostic tool in the case of anti-kell (except to see whether the baby does have the antigen or not, if that is in question) because the anti-kell antibody is unique in that it can kill the stem cells before they become red blood cells. So the bilirubin might not be particularly high (which is what they look for in amnios with rh affected pregnancies) because the stem cells never have a chance to become red blood cells.

They really try to get you as far along as possible, but if it is a severe case, the baby may legitimately be safer out of the womb than in with the antibody killing the red blood cells. So the baby might need to be born early. This was not the case with either of my sensitized pregnancies.

This is an excellent resource. The thread is called "Iso Moms Update" It is a huge thread started a couple of years ago with mamas that are dealing with isoimmunization. It is good for support and has a lot of information and resources.


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## lindseyL2507 (Jul 17, 2013)

Hello! I have a 6yr old daughter and after I had my Csection with her I had a blood transfusion. I have had 2 miscarriages in the past two years but after the second one they ran blood tests and I have anti kell. My test says my titers were too weak at 1:2 1:4 1:8. Is it my anti kell disorder that caused my miscarriages and will I not be able to carry a baby? I had both miscarriages before I was 10 weeks. I want another baby so bad it hurts but I'm afraid I won't be able to carry one. Any thoughts? I go see a MFM next week. Thanks in advance.


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## meme12 (Sep 21, 2013)

Channel of peace I would LOVE to pick your brain. I just was informed that I have anti K my titre is 32. I am scared to death. We are 12 weeks pregnant with a little girl (Oona). We meet with the maternal fetal specialist this thurs and I would like to go in with as much info as possible. THANK YOU! These stories are giving me hope!!


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