Posted by
Meiguoren
19 yrs ago
I'm sure Dr. Peggy Lu at Can Am will give you good advice, and they regularly get pharmaceuticals from HK. Also, take this experience as representing the tip of the iceberg -- nuff said.
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When we started our OB unit 9 years ago in beijing this was one of our major nightmares and continues to be so. Anti-D is NOT licensed in the mainland. If you are careful some medications can be brought from HK BUT Anti -D is a BLOOD PRODUCT and the authorities are not happy about BPs coming across the border (Dont tell me HK is now China, we all know that is only a half-truth)also it has to be kept frozen. I suggest you have the baby, IF the baby is RH+ve, leave the hospital on the 2nd day and go to HK for the shot. Contact Lynn at the Matilda and see if they can help.
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Will be happy to help where we can and we do have it but as Dr Moreton mentions I can not get it to you, sorry.
We do have accommodation at the hospital if you did travel over though not easy and baby wouldn't have travel documents so quickly otherwise you could stay here.
I think you should really consider seriously delivering in HK, for the safety of you both.
If there is anything I can do please feel free to give me a call,
Lynne - 852-2849 0328
Matilda International Hospital
Hong Kong
http://www.matilda.org
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Thank you Lynne, for your input. Another problem that can arise. A couple can get the Anti-D and keep it, but if you have a RH-ve baby it is not necessary to get the shot. It is VERY expensive and cannot be returned. In Bj and SH we have a partial answer to these problems but as you are so close to HK I think that might be a good option for you.
The other thing that you need to check is if they have Rh -ve Blood available in Guangzhou, the number of mothers that need to be transfused during or after birth is very, very small but it is NOT zero. In Bj and Shanghai we have worked with the Blood Bank and have a volunteer donors list of westerners who will donate Rh-ve blood if needed , be sure that is available in Z.
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Thank you Lynne, for your input. Another problem that can arise. A couple can get the Anti-D and keep it, but if you have a RH-ve baby it is not necessary to get the shot. It is VERY expensive and cannot be returned. In Bj and SH we have a partial answer to these problems but as you are so close to HK I think that might be a good option for you.
The other thing that you need to check is if they have Rh -ve Blood available in Guangzhou, the number of mothers that need to be transfused during or after birth is very, very small but it is NOT zero. In Bj and Shanghai we have worked with the Blood Bank and have a volunteer donors list of westerners who will donate Rh-ve blood if needed , be sure that is available in Z.
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This is the main point. The danger is not to THIS baby but to the next. If you develop antibodies in this pregnancy they will attack the NEXT baby sometimes with awful results. This again is why there is little concern in China where officially there is no NEXT baby.
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cd
19 yrs ago
I too am B-, I've had the anti D shot after each birth plus after a miscarriage. But with my last pregnancy I had 2 shots during the pregnancy as well, that was here in HK. They said they were following the guidelines from the UK that now say it is better to have more than just the one after birth. If its your 1st baby then things should be fine, but if your next baby is rh+ thats when the problems start. They normally give you the anti d after a miscarriage as they do not know what bloodgroup the baby would have been.
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Good to see how things have changed. Way back when... mother - ve, father + ve, three kids all + ve and the last two were born at home. Of course back then the only people who knew what group they were were blood donors. Certainly gives peace of mind now, rather than the old ignorance is bliss approach.
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True, Anti D was first developed at my medical School, Liverpool in the UK, in 1963 but did not come into wide use until about 1966.
Initially it was given after birth if a Rh- mother had a RH+ baby. Immunization takes place usually during the separation of the Placenta when a small amount of fetal blood gets into the maternal blood stream. Later research in Cnada showed that a very small number of fetal>maternal transfusions took place during pregnancy and in many countries the mother is now given Anti-D at 28 weeks, unless the father is negative too.
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[sigh] another reminder that I'm old... that and the mumps or measles 'parties'. These days its worrying vaccines, back then it was putting all the neighbourhood kids in a room with an infected child.
I hadn't realised that the Anti D was developed in Liverpool. Another good thing to come from that city.
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Liverpool was also the first city in the world to have a Public Health department and a Medical Officer of Health--- Some would say "There is a good reason fot that"
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Hi momo8,
My 2 bits worth!
My blood group is O- and my husband's blood group is A-, so I didn't need the anti-D shot for the birth of my children. If your husband's blood group is negative, you won't need the anti-D shot either. If you are not sure of your husband's blood group, it is probably worthwhile for him to have a blood test to find out. It might save you a lot of trouble re: the anti D shot.
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That is true if both the father and mother are RH-ve then the baby will also be -ve and no shot is needed.
On the other hand I made a nearly made a terrible mistake some years ago, a mother was Rh-ve and so was her husband. I did not give anti D initially. I had assumed that her husband was the father of the baby when he was not. Luckily we always test the babys Blood group and the baby was +ve so we gave the shot.Following that I stopped testing the 'fathers"
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This issue does take some effort to resolve. That is why I posted about it in the Cross Culture marriage babies thread. Even here in BJ I had to go to a seperate clinic to get the shot (we call it Rhogam in US) and work out the arrangements with the hospital where I will deliver. This is not common in Asia, so it is not as readily available as in other places. Hope everything works out for the OP.
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Anti D or Rhogam is NOT approved in China. It is technically illegal to give it on the mainland, luckilty the authorities are not too hard line about it but it is a nightmare for the hospitals and clinics.
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Dr M> So what is approved in China?
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It is not that the authorities dissapprove of Anti D it is just not necessary to have it here. Their focus is on Chinese needs not on the needs of foreigners. The state FDA is MUCH tougher than it was even 5 years ago on Clinics importing non-approved drugs. They regularly make surprise vsits to our pharmacies and confiscate any non-approved items and fine us. Some of it is amusing, fluoride drops for babies are not approved and we were fined for having that in our hospital.
Giving Anti D as I said is illegal, that is why several hospitals will give it to their own patients but not give it to patients delivering in Chinese hospitals.
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It is not that the authorities dissapprove of Anti D it is just not necessary to have it here. Their focus is on Chinese needs not on the needs of foreigners. The state FDA is MUCH tougher than it was even 5 years ago on Clinics importing non-approved drugs. They regularly make surprise vsits to our pharmacies and confiscate any non-approved items and fine us. Some of it is amusing, fluoride drops for babies are not approved and we were fined for having that in our hospital.
Giving Anti D as I said is illegal, that is why several hospitals will give it to their own patients but not give it to patients delivering in Chinese hospitals.
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That's good. Now for the rest of the iceberg? Have you discussed with your doctor his rate of cesarean and under what circumstances is it required, what are their policies on presence of father at birth, anaesthesia types and availability and administered by whom, privacy of birth facilities, birthing rooms available, positions allowed for birth, fetal monitoring, separation of mother and baby, support for breastfeeding, rooming in, . . . and if there is a problem, what information can you expect to be told? Will language barriers be an issue if something technical comes up? What are the hospital's infection rates and infection control measures? Not saying you wouldn't also have some of these issues in Hong Kong (or anywhere else for that matter), but don't go into this blindly. Of course everything will be fine, but even more than in your home culture you would be wise to a LOT of questions and clarify whether your expectations line up with common practice or whether you need to have special physicians orders written up in advance. IMO, better to make a nuisance of yourself now with these troublesome questions than to later regret not having inquired!
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