Among the early blood tests a pregnant woman must endure is the Rh, or Rhesus, factor test which is a test to see if the woman is Rh Negative or Rh Positive, which can be an indicator of hemolytic disease.

When the mother has a negative Rhesus factor and the father has a positive Rhesus factor, it can result in a fetus that is positive Rh factor. Even though the blood systems of the mother and baby are separate while the baby is in the womb, there are times when the baby’s blood can enter the mother’s body. When this happens it can cause the mother’s negative Rh factor blood to naturally create antibodies against the baby’s positive Rh factor blood. This results in the body to treating the baby as it would an infection in the mother’s body, instead of the body recognizing that the baby is supposed to be there.

When the mother and baby have opposite RH factor blood, the mother will become sensitized and her body will begin making antibodies which will attack the baby’s positive Rh positive factor blood, causing the breakdown of red blood cells in the baby which can lead to anemia. In severe cases where this happens while the baby is growing in the womb, it can lead to illness, brain damage and even death of the fetus.

The good news is that, through early blood tests, the dangers of the Rh negative factor in women can be prevented. If a woman is found to have RH negative and the father to be RH positive, the woman can be given a shot of Rh immunoglobulin which is a blood product given through an injection, normally in the buttocks of a woman. The injection suppresses the ability of the woman’s blood to react to the Rh positive red blood cells coming from the baby.

Each shot of immunoglobulin, also known as Rhogam, lasts about 12 weeks. Some doctors will choose to give two shots, one at the beginning of the second trimester and one at the beginning of the third, at about 28 weeks. When the baby is born, if it is indeed has the Rh positive, the mother will be given another shot of Rhogam to help avoid the possibility of her body becoming sensitized to the Rh positive factor in later pregnancies.

Most women will test as Rh Positive, at which point there is no threat to the pregnancy. However, some women will test as Rh negative. If your blood work comes back showing that you are Rh negative, your doctor or midwife will mention it to you. However, if you have questions or are unsure if you fall into this group of women, make sure you ask your provider for the results of your blood work at your next appointment.

Amniocentesis, also referred to as simply an ‘amnio’, is a test that many women are offered and some take advantage of while pregnant. It is a test that analyzes the amniotic fluid that surrounds your baby while in utero. The amniotic fluid contains cells that match your baby’s and can give your doctor or midwife little clues and hints about your baby.

Amniocentesis is normally performed when a woman is between 15 weeks and 18 weeks pregnant. To perform amniocentesis your doctor or midwife will hook you up to an ultrasound machine and then insert a needle through your belly into the uterus and remove approximately 2 tablespoons of fluid to test and analyze. An amniocentesis can also be performed when you are 37 weeks or later in order to check your baby’s lungs and determine if they are mature enough for the baby could breathe on his own outside of the womb.

Amniocentesis is normally performed on women who are at high risk for a various number of reasons. These reasons might include

• Advanced maternal age (35 or older)
• Diabetes
• Previous children with medical problems at birth
• Abnormal triple screen results
• RH factor

Not only can amniocentesis determine if your baby is healthy or has any medical problems, but it can also unmistakeably determine the gender of your baby. For couples who want to know, ahead of the birth if they are having a boy or girl, is a pleasant and exciting plus to the amnio.

Amniocentesis is not done as a routine procedure during pregnancy because it does carry some risks. About 1 in 200 pregnancies will end in a miscarriage caused by the amniocentesis procedure. Therefore, an amnio is only performed when previous tests or ultrasounds suggest that there is a possibility of a severe medical problem. Even when this possibility exists, some women exercise their option of not having the test, and wait till their baby is born to deal with any problems he may or may not have. If you are not sure which choice is best for you, talk to your doctor or midwife.

2004 EPA and FDA Advice For:
Women Who Might Become Pregnant
Women Who are Pregnant
Nursing Mothers
Young Children

FDA, EPA Revise Guidelines on Mercury in Fish By Carol Rados

One minute you hear that eating fish is good for your heart. The next, you find out that eating certain types of fish can be harmful.

Actually, there are benefits and risks to eating fish. Fish and shellfish are an important part of a healthy diet. They contain high-quality protein, other essential nutrients, and omega-3 fatty acids, and fish are low in saturated fat. A well-balanced diet that includes a variety of fish and shellfish can contribute to a healthy heart and to healthy, well-developed children.

However, nearly all fish and shellfish contain traces of methylmercury, a type of mercury found in water that can be harmful, especially to unborn babies and young children whose nervous systems are still developing. Some types of fish and shellfish contain higher levels of mercury. The risks depend on the amount of fish and shellfish eaten and the levels of mercury in the seafood.

The Food and Drug Administration and the Environmental Protection Agency (EPA), through a joint consumer advisory, warn that women who may become pregnant, pregnant women, nursing mothers, and young children should avoid the types of fish and shellfish with higher levels of mercury and eat only those that have lower levels.

Here’s more information about the mercury in fish and shellfish, and what you should know.

Q. What is mercury and methylmercury?

A. Mercury occurs naturally in the environment and also can be released into the air through industrial pollution. Mercury falls from the air and can accumulate in streams and oceans. Bacteria in the water cause chemical changes that transform the mercury into methylmercury. It is this type of mercury that can be harmful to unborn babies and young children. Fish absorb the methylmercury as they feed in these waters. Methylmercury builds up in the tissue of some types of fish and shellfish more than others depending on what the fish eat. That’s why levels vary among species and locations.

Q. Should a woman who is not pregnant, but could become pregnant, be concerned about methylmercury?

A. Yes. If you regularly eat types of fish high in methylmercury, the substance can accumulate in your blood over time. Methylmercury is removed from the body naturally, but it may take more than a year for the levels to drop significantly. Therefore, it may be present in a woman even before she becomes pregnant. That is why women who are trying to become pregnant also should avoid eating certain types of fish.

Q. Do all fish and shellfish contain methylmercury?

A. Nearly all fish and shellfish contain traces of methylmercury. However, larger fish that have lived longer have the highest levels of methylmercury because it has accumulated over time. Large fish such as swordfish, shark, king mackerel, and tilefish pose the greatest risk. Other types of fish and shellfish may be eaten in the amounts recommended by the FDA and EPA.

Q. Where can I get information about the types of fish I eat?

A. Information about the levels of methylmercury in the various types of fish you eat can be found at the FDA food safety Web site: www.cfsan.fda.gov/~frf/sea-mehg.html or the EPA Web site at www.epa.gov/ost/fish.

Q. Should I be concerned about fish sticks and fast food sandwiches that are made with fish?

A. Fish sticks and fast food sandwiches are commonly made from fish low in mercury.

Q. Although advice is provided about canned tuna, what is the advice about tuna steaks?

A. Because tuna steak generally contains higher levels of mercury than canned light tuna, when choosing your two meals of fish and shellfish, you may eat up to 6 ounces of tuna steak per week.

Q. What will happen if I eat more than the recommended amount of fish and shellfish in a week?

A. One week’s consumption of fish does not change the level of mercury in the body much. If you eat a lot of fish one week, you can cut back for the next week or two. Just make sure to average the recommended amount per week.

Q. Where can I get information about the safety of fish caught recreationally in lakes, streams, and rivers?

A. Before you go fishing, check the appropriate fishing regulations booklet for information about recreationally caught fish. You can also contact your local health department for information about advisories in your area. Check local advisories because some kinds of fish and shellfish caught in local waters may have widely varying levels of mercury, depending on the levels of mercury in the water. Fish with much lower levels may be eaten more frequently and in larger amounts.