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.
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.