Rh question

Specialties Ob/Gyn

Published

If a pregnant woman was Rh negative and tested positive for Rh antibodies, does she receive the Rhogam injection at 28 wks? If not, then what is the expected course of treatment for mom and baby? Thanks in advance for the help :)

What happens if antibodies develop?

Once a woman develops antibodies, RhIg treatment does not help. A mother who is Rh sensitized will be checked during her pregnancy to see if the fetus is developing the condition.

The baby may be delivered on time, followed by a blood transfusion for the baby that will replace the diseased blood cells with healthy blood.

For more severe cases, the baby may be delivered early or given transfusions while in the mother's uterus.

Taken from:http://www.americanpregnancy.org/prenataltesting/rhfactor.html

Do you know how you developed the antibodies? Just curious.

Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.

it's devastating to the child, who will likely undergo massive and complete blood exchanges. long term health consequences often. I have friend who had an RH affected baby....he has all kinds of issues with his immunity (or lack of it)

Specializes in NICU, PICU, educator.

They will closely monitor your baby....it is at risk for Hydrops. You may undergo several umbilical blood samplings and the baby may need transfusions as when the antibodies are present, they attack the baby's red blood cells and thus the baby becomes anemic while still in utero.

These kids can be very hard to manage, but there are some that do very well too. The breakdown is:

Mild Rh disease: involves limited destruction of fetal red blood cells, possibly resulting in mild fetal anemia. The fetus can usually be carried to term and requires no special treatment but may have problems with jaundice after birth. Mild Rh disease is more likely to develop in the first pregnancy after sensitization has occurred.

Moderate Rh disease involves the destruction of larger numbers of fetal red blood cells. The fetus may develop an enlarged liver and may become moderately anemic. The fetus may need to be delivered before term and may require a blood transfusion before or after birth. A newborn with moderate Rh disease is watched closely for jaundice.

Severe Rh disease (fetal hydrops) involves widespread destruction of fetal red blood cells. The fetus develops severe anemia, liver and spleen enlargement, increased bilirubin levels, and fluid retention (edema). One or more blood transfusions may be necessary before birth. A fetus with severe Rh disease who survives the pregnancy may need a blood exchange. This procedure replaces most of the infant's blood with donor blood (usually type O, Rh-negative).

Thank you all for your responses. This was related to a test question and my books did not give a clear answer. I thought since it was an immunoglobulin that maybe it could be given in a series but obviously not. Good explanations!

Do you test positive for Rh antiboties after receiving the rhogam shot?

Specializes in Emergency Dept, M/S.

I had a friend become Rh sensitized, and they didn't know how because she'd never been pregnant - supposedly. Going back over her menstrual history, they discovered she'd probably had a miscarriage without knowing she was pregnant, since her cycles tended to be sporadic, and she wrote it off as a late, heavy period. They knew it didn't come from the baby she delivered because he was Rh-.

I'm clueless how it all works, even though I'm negative and got Rhogam at 28 weeks and after delivery each time because my kids were positive. Also got it after a miscarriage.

It would make for an interesting paper though. I'm always looking for topics like this!

Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.
Do you test positive for Rh antiboties after receiving the rhogam shot?

should NOT if a person receives rhogam injection before being sensitized, within 72 hours of a childbirth or abortion/miscarriage.

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