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Discussion

RhoGAM: when does mom get it?

When an Rh negative mother is carrying an Rh positive fetus, when does she recieve RhoGAM? Is it at 28 weeks, or 72 hours after birth? Or both? Having a hard time getting clarification on this from my textbook.

Also, does anyone know if RhoGAM is the same thing as Rho(D) IG? I read something online about the latter: apparently, it's an injection that is actually given multiple times throughout the course of pregnancy...is that something different from RhoGAM?

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Jedi,

RhoGAM is given at both times or given if pregnancy is terminated at 13 or more weeks gestation. RhD IG is the same thing. I would definitely look this up in a drug guide (I know I sound like an instructor) but that is the best way to learn about it. Hope this helped.

Along with at 28 wks and 72 hrs after birth its also given if an invasive procedure is done on mom (amniocentesis).

RhoGAM is given when the neg mother has a miscarriage or abortion but the time depends on the facility. Some have a cut off in weeks and some do it no matter what. If the mother keeps the pregnancy it's given at 28 weeks and 72 hours after birth or when the mother has any invasive procedure involving the uterus (amniocentesis).

RhoGAM is the same thing as Rho(D) IgG. I believe the only difference is that Medicaid will not pay for RhoGAM but will pay for Rho(D) IgG (at least in Fl).

Also remember that it is a blood product and depending on what your going to school for LPN/RN you may not be able to give it. When I was working as a MA I could but when I get my LPN license I won't be able to because in Fl we are not able to give blood products.

  • Expert

generic name: RHo(D) Immune Globulin, RHo(D) IG, (brand names: Rho-GAM, Gamulin Rh)

"ACTION

Prevents production of anti-Rh(D) antibodies in Rh-negative women who have been exposed to Rh-positive blood by suppressing the immune reaction of the Rh-negative woman to the antigen in Rh-positive blood; prevents antibody response and thus prevents hemolytic disease of the newborn in the future Rh-positive pregnancies. Used for both males and females who are Rh-negative but exposed to Rh-positive blood or for immune thrombocytopenic purpura (ITP).

INDICATIONS (PREGNANCY RELATED
)

Administered to Rh-negative women who have been exposed to Rh-positive blood by:

  1. Delivering an Rh-positive infant.

  2. Aborting an Rh-positive fetus.

  3. Having chorionic villus sampling, amniocentesis, or intraabdominal trauma while carrying an Rh-positive fetus.

  4. Receiving inadvertent transfusion of Rh-positive blood.

DOSAGE AND ROUTE
One
standard
dose (300 mcg) administered intramuscularly:

  1. At 28 weeks of pregnancy and within 72 hours of delivery.

  2. Within 72 hours following termination of a pregnancy of 13 weeks or more of gestation.

One
microdose
(50 mcg) within 72 hours after the termination of a pregnancy of less than 13 weeks of gestation.

Dose is calculated based on the volume of fetal-maternal hemorrhage or Rh-positive blood administered in transfusion accidents. A standard dose will protect against 30 mL of Rh-positive whole blood or 15 mL of packed red blood cells (RBCs) (Weiner & Buhimschi, 2004).

ABSORPTION

Well absorbed from intramuscular sites.

EXCRETION

Metabolism and excretion unknown.

CONTRAINDICATIONS AND PRECAUTIONS

Women who are Rho-positive or women previously sensitized to Rho(D) should not receive Rho(D) immune globulin. It is used cautiously for women with previous hypersensitivity reactions to immune globulins.

ADVERSE REACTIONS

Local pain at intramuscular site, fever, or both.

NURSING CONSIDERATIONS

Type and antibody screen of the mother's blood and cord blood type of the newborn must be performed to determine the need for the medication. The mother must be Rh-negative and negative for Rh antibodies. The newborn must be Rh-positive. If the fetal blood type after termination of pregnancy is uncertain, the medication should be administered. The newborn may have a weakly positive antibody test if the woman received Rho(D) immune globulin during pregnancy. The drug is administered to the mother, not the infant. The deltoid muscle is recommended for intramuscular administration."

(pages 469-471,
Clinical Companion for Foundations of Maternal-Newborn Nursing
, 4th edition, by Sharon Smith Murray and Emily Slone McKinney.)

I am rh - and have two kids. So I will share the plain jane version everyone rh - person gets it at 28 weeks or if they have a miscarriage.......... after birth they test the babies blood and only if the child is rh + do you get the shot after birth. My first child is rh - but my second is rh + and i only got the shot with the second. hth

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