RhoGAM and Coombs

Specialties Ob/Gyn

Published

I'm a nursing student and we just took our OB final this morning. There was a question on the test that I'm confused by and I was hoping someone might be able to explain.

Let me preface by saying that when we covered this material, we ran out of time and so we never had lecture on this and we were told that it wouldn't be on the test. It wasn't on THAT test, but it showed up on the final. I guessed, but looking at the book and the notes, I'm not sure what the right answer is.

The question had to do with when to give RhoGam. Two of the four answers were obviously wrong. The other two were: "if both direct and indirect Coombs tests were positive" and "if both indirect and direct Coombs tests were negative."

I guessed both positive (seemed logical in that we hadn't talked about it and since we were told it wouldn't be on the test, I didn't even read about it!). Afterwords, a classmate of mine who works as a tech in OB said that was right, but when I looked at the Powerpoint for that lecture, it says you give it if they're both negative. The book only mentions it in one sentance and it's unclear.

So, which is it? I've read a lot about Coombs testing online and it seems to me that it would be if they were both positive you'd give the RhoGam, but the Powerpoint specifically days to do it if they're both negative. Can someone tell me which is right and explain why?

I'm hoping that they'll throw the question out since they did say it wouldn't be on the test, but I'd still like to know for myself.

Thanks!

Bryan

Hey guys. I am studying for my ob hesi and I thought I would let you know that my hesi review book states that if a mother has a positive coombs test that she does not need rhogam. This is because she is already sensitized. PG. 269, Hesi review book if you guys have the book as well.

this is my answer

Rh (D) immune globulin (RhoGAM) is given only if antibody formation has not occured.

a negative Coomb's test confirms that antibodies have not been formed. the shot is als recommended within

72 hours after birth, miscarriage, abortion, ectopic pregnancy, or amniocenteses.

Rh - immune globulin contains antibodies to the Ph factor. these antibodies seek out the baby's Rh+ blood in the mother's bloodstream, attach to it, and destroy it before the mother can make antibodies of her own. Rh-immune globulin's protective effect last for about 12 weeks, so the shot will be given again during future pregnancies.

I miscarried 3 weeks ago and had D&C done early this week (10 weeks). My Blood type is A+ve and I am aware that I do not need the RhoGAM due to my bld type. Will I still need to have the Coombs test? Would it affect my future pregnancy?

thanks so much

I'm a nursing student and we just took our OB final this morning. There was a question on the test that I'm confused by and I was hoping someone might be able to explain.

Let me preface by saying that when we covered this material, we ran out of time and so we never had lecture on this and we were told that it wouldn't be on the test. It wasn't on THAT test, but it showed up on the final. I guessed, but looking at the book and the notes, I'm not sure what the right answer is.

The question had to do with when to give RhoGam. Two of the four answers were obviously wrong. The other two were: "if both direct and indirect Coombs tests were positive" and "if both indirect and direct Coombs tests were negative."

I guessed both positive (seemed logical in that we hadn't talked about it and since we were told it wouldn't be on the test, I didn't even read about it!). Afterwords, a classmate of mine who works as a tech in OB said that was right, but when I looked at the Powerpoint for that lecture, it says you give it if they're both negative. The book only mentions it in one sentance and it's unclear.

So, which is it? I've read a lot about Coombs testing online and it seems to me that it would be if they were both positive you'd give the RhoGam, but the Powerpoint specifically days to do it if they're both negative. Can someone tell me which is right and explain why?

I'm hoping that they'll throw the question out since they did say it wouldn't be on the test, but I'd still like to know for myself.

Thanks!

Bryan

I am taking the Kaplan prep class on-line and was surprised by this right answer. It states that RhoGAM is giving when mother is Rh negitive, baby Rh positive and there is a negitive direct Coombs test. FYI... (I'm so confused!)

+ Add a Comment