R.V. Doon

RhoGAM: A life-saving treatment for Rh negative women and their newborns

Once upon a time there was no treatment for Rh negative (Rhd) mothers making antibodies against their RhD positive babies. Read my article HDN to learn about the scope of the problem. The heart ache ended when RhoGAM became available as a viable treatment to protect mothers and infants. The first injection to a postpartum Rhd mother occurred on January 31, 1964.

“Kath” a relative of Dr. Gorman who was working on bringing the treatment to market, took the first intramuscular injection before clinical trials in women were begun. The drug was a success! Kath felt no ill effects and her blood test later showed no antibodies to her baby’s blood.

 

blood thread-blood bags 2

Warning: If your blood work shows you’ve already been sensitized, RhoGam and similar products aren’t for you.

RhoGAM is one brand of the generic Rh immunoglobulin (RhIg) therapy. RhIg is an injectable drug given to women with Rh-negative blood during pregnancy. The main purpose of RhIg is to prevent problems (see HDN) in case the baby has Rh-positive blood. There are many versions of this drug in 2015, but I prefer RhoGAM because it was the first and makes its drug from a selected volunteer population.

The volunteers are all Rh negative women who depended on the RhoGam product. Many have donated regularly for over 10 years. Other companies gather plasma from hundreds of unknown donors. You can read about the donors and the product on the RhoGam website.

RhIg is given to a pregnant woman with Rh-negative blood in two doses as an intramuscular injection. The first at 28 weeks and the second within 72 hours of the baby’s birth. The first dose is smaller than the second and yes, at this point the baby’s blood type is unknown.

The second dose should only be given if the baby is born RhD (Rh positive). If your baby has Rh negative blood at birth, refuse this second shot. Or demand the nurse call the doctor or ask him to visit you first. All he/she has to do is look it up at the RhoGam website. Please be aware some doctors tend to error on the side of safety if you’ve had a problem pregnancy.

RhoGam or any other version of RhIg therapy prevents your body from forming Rh antibodies, which won’t harm your first baby, but will harm any future babies you have if they’re Rh-positive. Rh antibodies lead to a baby being born with hemolytic disease of the newborn (HDN), which can cause severe anemia, blood transfusions, or death.

RhIg is also given to Rhd mothers with bleeding, abdominal trauma, amniocentesis, versions,  abortion, ectopic  pregnancy, molar pregnancy, miscarriage, or placental biopsy.

Again, if a blood test shows your body is already making Rh antibodies, RhIg injections won’t help. In that case, your OB doctor will keep a close eye on your baby using the old standby treatments and procedures.

When physicians added the dose at 28 weeks( 1975), the death rate from HDN became miniscule. A truly amazing feat!

Special Note: While I’ve had 3 doses of RhoGAM, I never experienced any side effects, others have. I’ve found this article written by a doctor which I think describes side effects the best. If you’re making choices on the future health of your children, consult professionals for information.

If you have concerns about getting RhoGAM injections at the 28 week point discuss your fears with your doctor. I applaud any woman who reads on a subject, consults professionals, and makes informed decisions. The important point is to clarify what bothers you before you reach 28 weeks.

For those who want to see how John Hopkins manages treatment read here. Chapter Eighteen pages 231-238. Also the algorithms used for treatment may be interesting to laymen.

 

My next article will trace the historical map from Idea to RhoGam for those interested. This story is amazing, incredible, and long.

Please see my other articles in the Rh negative blood series:

The Historical Perspective

Monkey Blood, Blue Blood

Blood Feud

HDN

The New Math

Rhd Dictionary

 

 

 

 

 

 

5 thoughts on “RhoGAM: A life-saving treatment for Rh negative women and their newborns

  1. Debbie

    Thank you SO much for responding so quickly with your honest opinion and advice.

    Just to be clear, you are a firm beliver in the benefits of receiving RhoGAM during pregnancy (28 weeks) as well as within 72 hours after delivery? The potential risks to the fetus from the prenatal injection was the one troubling me. They both received RhoGAM after the birthds of their first child and will be again.

    I appreciate the tip to have their doctors request thirmasol free injections prior to delivey.. I would never have thought of that. You have no idea how much I appreciate a sound voice from someone who has been through this.

    1. R.V. Doon Post author

      Hey Debbie,

      Sorry to be slow on the follow up. Yes, I do support the shot at 28 weeks. This wasn’t offered to me with my first child, but the doctor brought it up with my second. My question wasn’t about the mercury, but what happened if my unborn child was actually Rh negative? The reply was nothing. The RhIg shot (is specific antibodies) prevents active immunity to the D antigen (Rh negative.) If the antigen isn’t circulating because there is no mismatch or blood exchange between mother and baby, the antibodies in the shot fades away. Antibodies are warriors, if there is no war to fight they leave. My second child was Rh neg, so naysayers could say I took an unneeded treatment. My reply is it didn’t harm him or me. If he had been Rh + and the D antigen was circulating, my body would’ve attacked his. This would compromise his development in more ways than the RhoGAM.

      Now that the 28th week injection is considered the “gold care standard” most doctors will insist on the injection. It’s not just a liability issue, but now its recognized as best practice. This is why I suggested to voice concerns before the 28th week because some women have had side effects. (If your daughters have had the shots without side effects before, they most likely won’t have any the second round either).

      There are some people who suggest that they have autoimmune problems in adulthood because they were Rh+ and their mothers were Rh-. These people are older and most likely their mothers didn’t receive the 28 week injection. I haven’t checked into this as much as I should have. But if true, the 28th week injection may stop such problems. When I get back to the biomed library, I’ll check into this more.

      Your daughters are lucky to have you as their advocate.

  2. Debbie

    I have thoroughly enjoyed reading your articles this evening on RH negative blood. My husband and I are both positive blood types but two of our three daughters were born with RH negative blood. They are both currently pregnant (second pregnancies). Each of them received the RhoGAM shot after their first deliveries. Their doctors plan to give them another injection at 28 weeks. You mentioned your reason for documenting this subject was because there is a lot of misinformation out there on the internet. I have found that to be true and have some concerns. I have read that getting the RhoGAM shot during utereo can cause neurological damage to the baby and even autism because of thimerosal. I have read conflicting reports that the mercury has been removed. I have also read the mother should ask for a thimerosal free product. Since you are the mother of two sons who received three RhoGAM shots and did extensive research on this subject, could you shed some light on the fears of a loving mother/grandmother. Thank you so much for listening to me.

    1. R.V. Doon Post author

      Thank you Debbie. I’m writing a bigger “historical” background article on how RhoGAM was developed. It’s a great story, but I’ll have to break it up into sections.

      1. R.V. Doon Post author

        Debbie, I hit reply to fast. As for the safety questions, you can ask for the thimerosal free injection…but here’s the deal. Tell the RN you want to see the insert box when she comes in to give the injection. Most RN’s load their syringes in a medication area, or at the medication cart. Boxes are put in the trash when opened. So your children should tell the doctor they want a mercury free shot, and let the nurse know she wants to see its mercury free herself to calm any fears. It’s possible your hospital won’t have the mercury free shot on hand, and since you have a 72 hour window, be sure the doctor orders it before the delivery date or you’ll get what’s in stock.

        As for the autism question, I agree this is difficult. When I took the shots the rate of autism was 1 in 10,000, now it is 1 in 50. I personally don’t understand why there isn’t a public health war on autism. But if your daughters choose not to take RhoGAM and have an Rh positive child, they will most likely not be able to have another one without serious medical issues. There is a long and horrid history that makes that statement true. This is a fact and is irrefutable.

        As an Rh negative mother, I’d refuse flu shots during pregnancy and for my baby long before I avoided the RhIG injections like RhoGAM. People will be angry I made such a statement, but I stand by it. A few articles I’ve read about this does stir the fear and the reason is because the autism rates are skyrocketing. I hope all goes well for your daughters.

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