A fascinating explanation of how titers are figured, written by a mom on the ISO board on babycenter.com

When we run titers we grade the dilution and the strenth of the reaction. We basically add a set amount of your serum with a set amount of donor cells that have the corresponding antigen to your antibody then incubate then spin in a centrifuge.(we do serial dilutions on these specimens) We then take each test tube with the dilutions and gently shake the congealed cells at the bottom. If the cells stay clumped then the tube is positive. We grade the clump----4+ is a clump that stays in one piece, 3+ is 2 large pieces---we go all the way down to microscopic clumps. Each grade is also given a number called it's strength. Once we know the dilution then we add up all the strength numbers to come up with one number which we also report. This is to normalize the titers since titer levels can vary depending on what lab does it and what tech does it since it is all a manual procedure and thus leads to variations. A titer that rises by 2 dilutions and with a strength that increases by 10 is considered significant. Even if your titer goes up or down by a dilution if your strength doesn't increase or decrease by 10 then that would be consistent with no change. Hope this makes some sense since it is kind of a long winded explanation.

wow

http://www.pmrc.org.pk/PJMR44_3/Severe%20RhDalloimmunisation%20A%20Miraculous%20Suppression%20of%20Immunogenicity.pdf

Amazingly, some people have found that chewing a certan seed can lower your rh titer pretty significantly.

fact for today

- Nonresponders. About 30-35% of Rh- negative individuals can not be immunized by Rh-positive antigens. This characteristic seems to be genetically controlled but depends on the amount of the inoculum to a certain degree.

Doesn`t that just suck?

Latest good news in treatment

Effect of plasma exchange and immunosuppression on Rho(D), viral, and bacterial antibody titers in Rh-immunized women.
Am J Reprod Immunol. 1982; 2(1):46-9 (ISSN: 0271-7352)
Scott JR; Anstall HB; Rote NS; Kochenour NK; Beeson JH

Pharmacologic immunosuppression and plasmapheresis have both been advocated as adjunctive methods of treatment for Rh immunization, but a combined regimen of the two has not been attempted. We treated four nonpregnant, severely Rh-sensitized female volunteers with intensive plasma exchange and either promethazine 150 mg or prednisone 60 mg per day in an attempt to remove circulating anti-Rho(D) and prevent further synthesis of the antibody. Each patient received three or four exchanges. The Rho(D) antibody titer decreased by at least one dilution immediately following 11 of 14 plasma exchanges and was ultimately lowered at least two dilutions in all patients. In one case the titer was reduced from 1:512 to 1:16, and a low titer was maintained for the duration of treatment. However, this regimen could increase the risk of infection for a mother and/or infant, as evidenced by the concomitant lowering of viral and bacterial antibody titers in these women.

The very first post

Bear with me because I am not a good writer these days or a very creative thinker since I`m busy growing my 4th boy. All of my thoughts feels stunted, but I realized there weren`t many places for isommunized mamas on the web. I will try to give a feel for what you might deal with with an antibody, specifically anti-d, and link or share any new info I might find.

Quick little blurb on isoimmunization: Suppose a woman is Rh-negative and her husband is Rh-positive. Her fetus may be Rh-positive or Rh negative. Suppose she has an Rh-positive fetus. During delivery blood from her D-positive fetus can pass on to her blood. She will develop antibodies against Rh-D antigen. These antibodies can pass from mother to the fetus during next pregnancy. During next pregnancy if she again has an Rh-positive fetus. Anti-D antibodies in her blood will cross the placenta and get into the fetal blood. These antibodies will destroy the blood in the fetus. With each exposure to Rh-positive blood the amount of antibodies formed increases. Therefore the risk goes on increasing to the Rh-positive with each subsequent pregnancy.

4. To avoid this first the Rh-D status of the pregnant women is determined. Her blood is tested. If she is Rh-negative (i.e. does not have Rh-D antigen)the Rh status of the husband is determined. If the husband is Rh-negative no action is taken. Suppose he is Rh-positive, the mother is given anti-D to destroy the fetal cells that may have entered her circulation to prevent her developing anti-D antibodies.



I`m 31 weeks into my 2nd ISO pregnancy, so far so good, I don`t want to say too much until its behind me. I got sensitized when my second son was born, he suffered a severe birth injury (shoulder dystocia) and lost too much oxygen and passed away when he was 7 weeks old. We still think about him every single day. After he was born, I had a horrendous hemmhorrhage and the Rhogam shot I was given to protect me from making antibodies to my rh + children did not work. When a mother loses a lot of blood she needs more Rhogam & in my case it just wasn`t enough. Its nobody`s fault, it could never have been enough, not to mention that Rhogam is not 100% effective anyway.

So here I am, going down the anti-d road again, of course my dear husband is homozygous for anti-d, meaning he only can make an rh + kid & I will only ever have rh- blood. This condition scares the pants off of most obstetricians, but a skilled perinatalogist usually knows what to do and how to get the healthiest possible baby at the end. The good news is that isoimmunized babies (also known as Coombs positive) have great outcomes, once they get past the possible initial anemia.