Positive Coombs Test in Newborn

I was injured when I was 7 months pregnant, when my baby was born he was severely jaundiced. A few weeks later he became anemic. He had to be life lighted at a week old, and on bililights for 3 months.

His doctors said he had a positive coombs test, even though we have the same blood type. Apparently it happened when I fell. The doctor also said if I have another baby that baby will have the same issues and may have to be taken early.

My husband and I would like to have another baby but we want to know the chances of it happening again and the worse case scenario. The doctor is not being helpful and just says he will monitor me if I would become pregnant again. We are military so I cannot change doctors either. Any info would be great.

Answer:

A positive Coombs test results from some type of blood type incompatibility, from what I understand. It's most common with Rh incompatibility (when mother is Rh- and baby is Rh+) but it can also occur for other blood type differences. The second most common is ABO incompatibility – an O mother's blood can create antibodies against an A, B, or AB baby's blood. Generally this reaction is not as severe as an Rh-/Rh+ reaction.

There are also other antibodies that can be formed against groups in the baby's blood, though they are rarer – the Kell group, Rh e, and Rh c are some examples. Ask your doctor exactly what your body has formed antibodies against, because there must be something for your little one to suffer severe anemia. You deserve to know what is going on!

An Indirect-Coombs test done on you can help you to know what you have been sensitized against, though the Coombs test on your baby should have given you that information, too. Perhaps you can request a copy of your baby's lab work.

A sensitized pregnancy is generally a more high-risk pregnancy. Your next pregnancy will be monitored throughout to asses the health of the baby.

There are non-invasive tests that can now be done to help a perinatologist determine the Rh status of the baby in the womb, though I'm not sure if they can determine ABO blood type, Kell, or any of the other variations yet. However, information from one of these tests could be invaluable to your doctor.

There is a forum at Babycenter that's quite active for women who are going through a sensitized pregnancy (of all types) – you may find it helpful:

Antibody Isoimmunisation group

I would start by getting more details on exactly what you because sensitized against while pregnant with your son, because it's important to understand what you are dealing with.

Best of luck to you and feel free to share what else you discover!

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About the author 

Kristen

Kristen is childbirth educator, student midwife, and a mama to 8 - all born naturally! She has spent years helping mamas have healthy babies, give birth naturally, and enjoy the adventure of motherhood. Find her on her website NaturalBirthandBabyCare.com and helping families through her online childbirth class MamaBabyBirthing.com

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