Question

Postpartum:

Susan P. had an SVD (spontaneous vaginal delivery) today approximately 2 hours ago. The labor and delivery nurse is calling to give you report. She is new and not sure what you want to know from her. Note that you discover that Susan is Rh-negative, her baby is Rh positive. What now?

** Please discuss Rhogam. The drug, the need, the route, the risk.

** When must you give this and under what circumstances will you give this injection?

** Please also recall any other reason Rhogam would be given, and when.

Answer 1

Sensitized means that the mother is developing antibodies against the baby with Rh-positive blood.

Anti-D antibody develops in Rh-negative mothers with Rh-positive babies

**RhIg usually is given to a pregnant woman with Rh-negative blood around 28 weeks and within 72 hours of baby's birth(if the baby is Rh-positive).

The drug prevents the maternal body from forming Rh antibodies, which aren't likely to harm the first baby but could actually harm any future babies if they are Rh-positive.

Rh antibodies could cause the baby to be born with hemolytic disease of the newborn.

Rhogamis a prototype drug. Rhogam is one brand of Rh immunoglobulin (RhIg). It is an injectable drug given to women with Rh-negative blood with Rh-positive baby.

Actions: Rh immunoglobulins are concentrated immunoglobulin preparation that contains antibodies to Rh. These antibodies destroy any fetal red blood cells in the maternal circulation and prevent an Rh-negative woman from developing antibodies after exposure to Rh-positive blood.

Uses: Prevents sensitization in the Rh negative pregnant patient when given in the last trimester of pregnancy as well as after abortion or miscarriage.

-Rhogam is administered as an IM injection usually in deltoid-300mcg-1vial if<15mls mixes.

If in case of IV it can be needed to be reconstituted with NS

The adverse reaction is mild and uncommon. It may include:

Hypotension, Chills, Dizziness, Fever, Headache, Pruritis, Rash, abdominal pain, diarrhea.

Injection site reaction includes discomfort, mild pain, redness, swelling

**Prophylactically at 26-28 weeks or 72 hours after birth, after amniocentesis, chorionic villi sampling, percutaneous umbilical blood sampling, obstetrical manipulation, ectopic pregnancy, abdominal trauma, miscarriage,abruptio placentae, placenta previa,c-sections or abortion after 12 weeks gestation

** It can be given under any other circumstances any risk of fetal/maternal hemorrhage or trauma in which baby's blood could mix with mother's.