Q: I am Rh negative and my husband is Rh positive. Three years ago, we had our first baby. I didn't take any shots during my pregnancy because of which my baby is also Rh negative. Now I am 24 weeks pregnant with my second one. My concern is that do I have to worry now and take the shot at 28 weeks or shall I wait until delivery? What is the chance of being sensitised this time? Is blood transfusion to the new born safe?

A:There is a risk of isoimmunisation, and problems to the baby, if the blood group of your baby is Rh positive this time. Repeated ultrasound scanning and testing of the mother’s blood for indirect Coombs' test (ICT) antibody titres will indicate if your baby is getting affected. If the baby gets affected, then a preterm delivery with exchange transfusion is done if the affectation is severe. In mild cases, there maybe jaundice only, which can be treated by phototherapy and correction of anemia after birth. Injectable rhogam shots during the pregnancy have a debatable role. You need to choose a good center with a good nursery facility for delivery.