Tuesday, 12 February 2013

Pregnancy and Chickenpox Antibodies Injection

On Friday my 6yr old came down with Chickenpox (See Pregnancy and Chickenpox

Friday evening my Doctor called to tell me the results of the blood test I had that morning, and it proved I wasn't immune to chickenpox and would have to have an injection of antibodies. Fair play to my Doctor he actually phoned up the hospital on Friday to chase up my results as I didn't think I would have them until Monday or Tuesday.

He explained on the phone that I had until this coming Friday to have the injection as there is only a 10 day window and because chickenpox is contagious before the spots appear, this window began 2 days before the spots. To be honest I wasn't surprised she caught them as she is the 10th child in her class to have caught them since Christmas and there's been at least 35 children in town infected with them since Christmas. 

We arranged that I would travel up to the hospital on Monday morning, as I was told the injection had to be given by an Obstetrician. So after dropping the girls off with my mum, my dad, the boy and I headed off to the hospital.

We got there quite early so we popped into the cafe for a cuppa, before heading up to the ward I had been told to go to. We got there and I explained to the nurse why I was there and she went to check my records on the computer before coming back and telling me she was ready. 

Now 90% of adults in the UK are immune to chickenpox, having had it as children, but as I haven't had chickenpox then I am in the 10% which isn't immune (ironically, so is hubby!) and this is why I had to be injected with chickenpox antibodies because chickenpox whilst pregnant can be dangerous for me and the baby and in extreme cases can even be fatal.

I went back in the room and the same nurse I'd spoken to said she would be giving me the injection and she mentioned she was surprised I hadn't had it at my local surgery instead of having such a long journey. I explained that I had been told an obstetrician would have to be the one to give it, but she said it didn't have to be. 

Now, as every pregnant woman knows, pregnancy is not glamorous  We're poked and prodded in areas where the sun doesn't shine and when we're actually giving birth we end up with a room full of people (not that we care at the time, we're in so much pain that a marching band could come in and we couldn't care less!) and this injection wasn't very glamorous either! There I was, showing my arm ready for an injection but instead being told to lie on my side and pull my pants down so I could be injected in my bum!

I have NEVER had an injection in my bum before, not even when I was injecting myself with insulin towards the end of my 4th pregnancy, then I was injecting myself in the slightly more glamorous thigh region. So there I am, baring my bum to the world and having a needle poked in it! Thankfully it didn't hurt too much!

The injection I had is known as Human Varicella-Zoster Immunoglobulin and is made from the blood plasma from screened donors who have had chickenpox and whose blood contains a large dose of antibodies. Antibodies are the fighters in your blood which the body produces when it feels it is under attack and these antibodies are trained to provide protection from chickenpox.

As well as being given to pregnant women who have come into contact with chickenpox whilst not immune, it can be given to newborn babies whose mother develops chickenpox within 7 days before or 7 days after the baby's birth, or newborn babies who come into contact with chickenpox when their mother isn't immune (so hasn't passed on the antibodies to her baby). It can also be given to adults and children who are not immune and come into contact with chickenpox who have a reduced immune system or by certain medications or certain treatments. As those are the people most at risk from chickenpox and serious and life-threatening complications. 

I asked the nurse whether this injection would make me contagious and I was reassured it wouldn't so I could go to work that afternoon and I also asked how long the protection would last. Sadly it only lasts 3 weeks and should one of my other children come down with chickenpox or I be exposed another way after 3 weeks then I will have to have another injection. 

There is also the risk of side effects, just like with any medication, but thankfully so far I feel fine. Side effects that may occur are;

  • Short term swelling, warmth, pain, redness, wound itching or rash at the injection site
  • Allergic reactions which may be serious with difficulty breathing or dizziness
  • Lightheaded, fainting or feeling faint
  • Headache
  • Chills, fever
  • Itching, redness of the skin
  • Rapid heartbeat
  • Feeling or being sick
  • Joint pains
Another thing I have to be aware of is that this medicine is made from human blood or plasma. This means there have been certain measures put in place to prevent infections being passed on to patients, these include careful selection of blood and plasma donors to make sure those at risk of carrying infections are excluded, and the testing of each donation and pools of plasma for signs of virus/infections Manufacturers of these products also include steps in the processing of the blood or plasma that can inactivate or remove viruses. Despite these measures, when medicines prepared from human blood or plasma are administered, the possibility of passing on infection cannot be totally excluded. This also applies to any unknown or emerging viruses or other types of infections. The measures taken are considered effective for enveloped viruses such as HIV, Hepatitis B and Hepatitis C. The measures taken my be of limited value against non-enveloped viruses such as Hepatitis A and Parovirus B19. Immunoglobulins have not been associated with Hepatitis A or Parovirus B19 infections possibly because the antibodies against these infections, which are contained in the product, are protective.

Despite these risks, since chickenpox in pregnancy, in newborn babies or in patients whose immune system is not working fully can have serious effects on health, the expected benefits of your medicine will usually be greater than the risks of suffering any harmful side effects. 

*** All the above information regarding the injection has been taken from the information leaflet which came in the box with the injection ***

One thing I have noticed since Friday is that it is really hard to find information about this injection, which made having it rather stressful and I hope by writing this post and sharing the information I received and what the treatment was like, I can help someone else who has to have this injection. 

So little information is known that my nurse couldn't answer my questions and she had to ask the head midwife and I still had questions when I returned home (was I contagious and how long would the protection last, both of which are covered in this blog post already). I even phoned the NHS Give Blood for information on whether this injection could mean you cannot give blood in the future as I know if you have had a blood transfusion you cannot give blood and I wondered whether the same rules applied to an injection made from blood. Their advice was to mention it when you next give blood (which the earliest it could be is when your baby is 6mths) as it would have to be considered on a personal basis based on your history, how many injections you have had and when. 

If you think about it though, it's not that surprising that so little is known. Only 10% of the UK population isn't immune and out of that 10% it means a woman has to come into contract with it whilst pregnant which lowers the chances significantly. For example this is my 6th pregnancy (my 2nd pregnancy ended in miscarriage at 13wks) and with 4 children at home, this is the first time I've had to deal with chickenpox and had I not been pregnant it wouldn't have been an issue!

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