# Rhogam



## SaraFR (Dec 8, 2005)

Forgive my ignorance,

Being that I'm not pg. (far as I'm aware-that nursing throws off your body), this isn't relevant currently. I'm more looking for food for thought. I did end up having the vax with both boys. This was before I was aware of most of the vax issues.

My question is, how can one have the Rh incompatability and not vax? What can you do instead to prevent the body from reacting to an Rh pos. baby?


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## maxmama (May 5, 2006)

In a nutshell, you can't.

It's unlikely to cause problems in a first pregnancy, or the first after having been prophylaxed in previous pregnancies. But I chose to prophylax, no sweat, because I'm already isoimmunized against another blood group factor (Kell) and I didn't need Rh isoimmunization on top of that.

Isoimmunization to Rh is not a minor problem. The prenatal treatments of an affected fetus are amniocentesis and in utero transfusion; after birth, some babies require a full exchange transfusion. Yes, isoimmunization is more likely after an abdominal trauma, but small utero-placental bleeds are quite common and can be enough to sensitize.

My experience with Kell has, quite frankly, scared the s*** out of me. It reminded me how common an experience isoimmunization was before RhoGAM, and how dismal the outcomes can be.


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## trini (Sep 20, 2005)

Can I jump on this thread and ask a related question?

Is it necessary to do it during the pg AND at delivery? Would it be effective to just do it at delivery, therefore preventing it from affecting the baby in any way?


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## Momtezuma Tuatara (Mar 3, 2004)

I don't understand why pregnant women have the jab when they are pregnant.

They have the jab because they are told if they have antibodies in the blood from a previous pregnancy that will damage the baby?

Well, keep in mind a very important point about RhoGam and that is that the antibodies attack ALL RH positive cells. The entire premise is that if the mother's blood mixes with the baby's blood, the antibodies will neutralize the baby's blood cells before the mother can create her own antibodies against the baby. The dilemna is that if the mother's and baby's blood does actually mix it is equally likely that the RhoGam antibodies will cross over and attack the baby itself. This happens frequently but isn't discussed by most doctors. It is a big reason to only get the shot after pregancy if the baby really is RH+

The RhoGam antibodies will attach to your baby's blood cells and render them incapable of delivering oxygen. This has long term consequences on brain development. Most doctors are completely ignorant of this issue.

The RhoGam antibodies do not cross the placenta. But neither do blood cells from the baby which is exactly why the RhoGam is injected. In very rare circumstances, such as the mother becoming injured, the blood of the mother and baby can mix. It's a paradox, only when the antibodies are needed can they harm the baby.

The RhoGam antibodies are put there to attack any baby's blood that comes across. But if there is mixing then the antibodies can go across the other way and they do exactly that. Antibodies diffuse much more readily through the bloodstream than whole cells.

Immunology textbooks still correctly point out that RhoGam should be given after childbirth only if the baby is RH+. These are the mothers that are at high risk. However the company that manufactures RhoGam lobbied to have it's use expanded to all RH- mothers during and after pregnancy to 'guarantee' that all high risk mothers were protected. Doctors try to rationalize this by saying that even during the first pregnancy blood can mix and antibodies can be produced that will attack the baby. This almost never happens because the blood would have to mix twice, once to stimulate the production of Abs in the mother and the second time for those antibodies to diffuse to the baby. And regardless, the paradox comes into play because if the mother's Abs can diffuse to harm the baby, then so can the injected RhoGam Abs. They are the same exact antibodies.

Each RhoGam injected contains blood serum pooled from several different persons with the antibodies. The manufacturer can not possibly screen or remove all viruses from it. But that's a separate issue.

The Rhogam antibodies in the injection are identical to the antibodies that the Rh- mother makes against her child. The Rhogam antibodies were collected from RH- mothers who did have an immune response to their RH+ babies. The Rhogam antibodies will attack and destroy the baby's red blood cells (if they do come across the placenta) before the mother's immune response kicks in and makes her own antibodies. You give rhogam to a mother after delivery because that is when the blood mixes. The rhogam antibodies destroy the baby's cells so that the mother's immune system never sees them and therefore never becomes sensitized to make those exact same antibodies.

If you give the Rhogam antibodies during pregnancy you have just created the situation you were trying to avoid. The whole point is for the pregnant mother to NOT have antibodies against her own child circulating in her system while she is pregnant.

Any blood mixing would allow those antibodies to attack the baby.

It does not matter if the mother's immune system made those antibodies or another mother's immune system (rhogam) made those antibodies. They are identical down to their molecular structure and you do not want them to contact the baby.


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## maxmama (May 5, 2006)

Quote:


Originally Posted by *trini*
Can I jump on this thread and ask a related question?

Is it necessary to do it during the pg AND at delivery? Would it be effective to just do it at delivery, therefore preventing it from affecting the baby in any way?

It's debatable. Yes, the largest blood exposure will come at birth. But it is possible to have a small utero-placental bleed with no symptoms, and that blood exposure could be enough to sensitize.

I freely admit my isoimmunization paranoia, because I never saw my Kell isoimmunization coming and it occurs the same way Rh sensitization does. Would the postpartum dose of RhoGAM be enough? Probably, for the vast majority of pregnancies. But I personally prefer to prophylax.


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## Momtezuma Tuatara (Mar 3, 2004)

Hmmm maybe I should rewrite that?


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## maxmama (May 5, 2006)

Quote:


Originally Posted by *Momtezuma Tuatara*
Hmmm maybe I should rewrite that?

I think we posted simultaneously. But I am a huge example of how possible it is to be sensitized during pregnancy. At the start of my pregnancy with my son, my Kell titer was negative. At my 28 week antibody screen, my titer was positive. At some point in that pregnancy, when I had not had any abdominal trauma or other known placental disruption, enough fetal blood entered my circulation to create an antibody response.

So yes, I do believe in "silent" isoimmunization, and if there was an equivalent to RhoGAM for Kell, I would have gotten it in a heartbeat. I'm spending this pregnancy in various perinatologists' offices discussing at what point in my titers I need a cordocentesis and transfusions, and when I become a hostile enough uterine environment that it's better for my child to be a micropreemie than continue being attacked by my antibodies. Right now, my titers are not rising and I'm hopeful. But I also know that utero-placental bleeds are most likely to occur in the third trimester, and I'm only 19 weeks.


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## Momtezuma Tuatara (Mar 3, 2004)

But your baby will not be damaged unless there is an event which will cause a second bleed. You are essentially in the same position as a person who has just had the shot.

You have antibodies which if you bleed again, could affect your babies, so you are actually in the identical position as a woman who has received rhogam. A woman who is given rhogam during pregnancy also has antibodies which, if she has a bleed and blood mixes will likewise damage her baby.

I don't understand why people don't see that.

It's basic, clear medicine.

The very argument you give here, shows WHY a woman shouldn't have rhogam during pregnancy.


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## caedmyn (Jan 13, 2006)

OK I'm not sure if I am understanding this right. Does it work the way a sensitivity to a bee sting does, in that the first exposure sensitizes but there won't be a reaction until the second exposure?

And if that is the case, in subsequent pregnancies is the person in the first exposure position, where a reaction will occur with one exposure in that pregnancy, or is that only if there was an exposure in the first pregnancy?

Hopefully that makes sense...


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## rozzie'sma (Jul 6, 2005)

I would suggest reading Anti-D in Midwifery panacea or Paradox by Sara Wickham. There are things that you can do to prevent the mixing of blood but it is not a guarantee that sensitization will not occur, It is a hard subject to think about. As an rh- woman myself who is only able to have rh+ babies dur to my dh being homozygous positive, I am going to refuse the 28 week injection but get the after birth injection. THe 28 week injection came about because docs were being lazy about informing women after a sensitizing event (blow to the abdomen, bleeding etc) that they need the shot and a small percentage of women were becoming sensitized. The 28 week shot is not even recommended in most european countries. Also they have been no studies done on what effects it may have on the offpring of a positive daughter whose mother recieved rhogam prenatally. It is not a black and white issue by any means. Please read her book, search your soul, and the answer will hopefully come to you. THis has been one of the toughest decissions of my life.


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## japonica (May 26, 2005)

This is all very interesting and I'm enjoying the food for thought...just thought I'd share my experience...

I am isoimmunized for anti-D. I was given Win-RHO (Canadian version of RhoGAM) during my first pg at 13 weeks (bleeding), 30 weeks, and at delivery. I was testing negative for antibodies up until delivery. We lost my daughter when I was 40 weeks pg and the follow up pathology on the placenta indicated that there was a "feto-maternal hemorrhage" (even though I had no signs of bleed) at the end of the pg (that and massive inflammation of the placenta--so some type of reaction was going on--no infections were found in my b/w results). With my second pg, the initial b/w indicated that I had become sensitized. I find your info very thought-provoking MT...maybe more was going on that we realized with the WinRHO. Like many people's experiences with vaxes, we were told that with me being Rh neg, it was just something we HAD to do...and also that it was almost 100% effective (so imagine my surprise when I found out I had been sensitized anyway after all those shots).

My second pg went fairly well...my DH is homozygous positive for D, so any additional pgs will be affected as well. My titers stayed fairly low (highest was 1:8), my DD did not become overly anemic and only needed the lights for a week, but no transfusions, after she was born.

We are considering trying for a third child and are meeting with the perinatalogist to get an idea of what to expect this time around.

Quote:

As an rh- woman myself who is only able to have rh+ babies dur to my dh being heterozygous positive
If your DH was heterzygous, would you have a chance that your baby could be neg for D? That was why we had my DH tested because of that possibility he could be +/- and we could end up with an unaffected baby...My DH turned out to be homozygous for D, so we're stuck with every pg being affected. Well, that's how it was explained to us anyway.

J


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## maxmama (May 5, 2006)

Quote:


Originally Posted by *Momtezuma Tuatara*
But your baby will not be damaged unless there is an event which will cause a second bleed. You are essentially in the same position as a person who has just had the shot.

You have antibodies which if you bleed again, could affect your babies, so you are actually in the identical position as a woman who has received rhogam. A woman who is given rhogam during pregnancy also has antibodies which, if she has a bleed and blood mixes will likewise damage her baby.

I don't understand why people don't see that.

It's basic, clear medicine.

The very argument you give here, shows WHY a woman shouldn't have rhogam during pregnancy.

If you look at the outcomes for babies whose moms received RhoGAM v. those whose moms were sensitized, you are going to be looking at two very different groups of babies. The RhoGAM babies have received, if any, extremely small doses of antibody, and there have not been negative efffects associated with it in reputable studies. These are essentially healthy babies.

The babies born to sensitized moms are at high risk for HDNB, hydrops fetalis (which, by the way, carries a mortality rate of approximately 50%; I really doubt you can come up with data that shows a congruent risk for receiving RhoGAM) and severe neurologic sequelae. Do I choose to avoid these known risks at the cost of a theoretical risk? You bet your ass I do, and my midwife, my perinatologist, my OB and the neonatologist I consulted with (all of whom have actually seen affected babies, as I suspect you have not) agree.

It's a risk-benefit analysis; for me, this is what I chose. At no point did I say that all women should get antenatal RhoGAM. What my point remains is that one does not know whether she will have a silent utero-placental bleed, and that needs to be factored into whether one chooses to have antenatal RhoGAM, which has documented efficacy and some theoretical risk.


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## SaraFR (Dec 8, 2005)

Both of my boys were neg. so the shot during the pregnancy ended up not being needed (not that we nkew the blood type till after birth).

Is it just as effective to get no shot during the pg. but get one postpartum IF the baby ends up being pos.?


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## rozzie'sma (Jul 6, 2005)

The US didn't used to do a prenatal Rhogam AT ALL. That didn't start till the 80's


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## SaraFR (Dec 8, 2005)

Was it added prenatally for money-making reasons or for effectiveness?

Athough, after being on the vax forum for a bit I'm willing to wager that the answer will be it was added for financial health.


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## Momtezuma Tuatara (Mar 3, 2004)

The information I posted here was put up some time ago, by someone else on the board, who is at the moment somewhat busy, but gave me permission to post it if it was needed.

I have asked them to come and explain, if they can find the time.

I understand the principles in the information I posted, that the poster was trying to get across.

There was another post posted by the person I've asked to come and explain, regarding rhogam to try to explain it further. This is what that post said:

Quote:

The rh+ cells of the baby stimulate rhogam production by the rh-mother's immune system. We want to prevent rhogam from circulating in the mother while she is pregnant because those antibodies will harm the baby. To do this we give rhogam immediately after birth so that any rh+ cells that are still in the mother will be destroyed. This keeps the mother's immune system from seeing those cells and producing her own rhogam which would stay in her circulation where they could attack any subsequent rh+ babies. Doctors would like us to inject rhogam antibodies during pregnancy to prevent the formation of rhogam antibodies. The rhogam will destroy all the rh+ cells thus preventing the mother from making her own rhogam antibodies. But what's the point, you prevented the mother's antibodies from being there by putting someone else's antibodies in the exact same spot. This is the point which I am not getting across: rhogam is the immune response to the baby. It is the pooled serum from rh- mother's who have had an immune response to their rh+ babies. You do not want those antibodies to come into contact with your rh+ baby.

Rhogam works. It works well. It should be administered after pregnancy like it is in Europe. During pregnancy is a decision that was made by the manufacturer to make money.

If a woman has a miscarriage she should have the shot immediately. If there is an amniocentesis performed it may be worth while to have the injection but there is some risk to that. It makes no sense to give the injection at 28 weeks during a healthy pregnancy. The blood does not mix in a sufficient manner to cause an immune response in the mother. If there were that much mixing then the injected antibodies (rhogam) would have access to the baby and kill the baby's red blood cells. It's a no win situation with rhogam at 28 weeks. The reason the manufacturer can get away with it is exactly because there is usually no blood mixing. The rhogam works it's way out of the mother's system without ever doing anything.

Another way to look at rhogam. Rhogam kills the baby's red blood cells no matter where those cells are. If the baby's blood cells are in the mother, those cells will be destroyed. If the baby's red blood cells are circulating through the baby delivering oxygen to the baby's brain, the rhogam will still kill those cells and deprive the baby of oxygen. It is not a good idea to take any chance that would allow the rhogam access to the baby. The doctors are concerned only about baby's cells circulating in the mother but antibodies diffuse much more easily than whole cells so the rhogam will readily find the baby's cells where the baby is than for the whole cells of the baby to find their way to the rhogam.

The makers of rhogam have funded some lame studies to show that getting the injection DURING pregnancy is more effective. I have found that most doctors are not intelligent enough to see the paradox becasue they blindly accept FDA and CDC recommendations. But there is a wonderful study that compared the efficacy of the post-natal vs. the ante-natal shot. The study examined the corporate studies and explained how they are flawed. It turns out there is absolutely no evidence to show that ante-natal is more effective than post-natal. So mothers should only get the shot post-natal IF the baby is rh+ (and the mother is rh-).

Here is a link to that study http://www.upstate.edu/fmed/cebp/Pre...ompilation.pdf You have to go to page 226

Page 234 summary on Th issues states

Quote:

6. We found no direct evidence of benefit of antnatal anti-D prophylaxis in terms of maternal or neonatal morbidity or mortality
Pg 236 makes the point that

Quote:

One Cochrane review of randomised trials of antenatal anti-D prophylaxis for Rh-negative women (Crowther 2000) See table 1. The reviewers searched for RCT's of the effect of antenatal anti-D prophylaxis for Rh-negative women after 27 weeks... only two trials were found. Both were of marginal quality (one with poor randomization scheme and the other with high dropout rates) ....The articles were appraised with the level of evidence shceme and described narratively and the results as qualitative comparison of the individual studies results....the overallquality of this evidence is fair to poor due to the lack of good quality RCTs and relinace on open label studies often with historical controls. There is no direct evidence that antenatal propphylaxis reduces maternal or neonatal morbidity or mortality or improves patient satisfaction....
the studies were weakly positive, but so weakly as to be meaningless in my opinion. Manufacturers are usually very good at constructing studies to prove their point, and if in those two studeis, they haven't been able to show conclusive benefit, then I'd wager there is none at all....

Fact. Rhogam antibodies cross the placenta and attack the baby's red blood cells (if the baby is rh+)? Well again it's just obvious but take a look at the package insert. Here's a quote from rhogam: *""Some babies born of women given Rho(D) immune globulin (human) antepartum have weakly positive direct antiglobulin (Coombs) tests at birth.""* There's your admission by the company. Weak or not the test proves the presence of the antibodies in baby's whose mother received the shot while pregnant. One antibody molecule can wipe out one red blood cell - that's all it takes. Any amount of antibodies is dangerous because it decreases the baby's red blood cells and hence the oxygen that the baby's brain receives.


Hopefully the person concerned will drop by. If that doesn't happen, you'll just have to put your thinking and decision making caps on.


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## SaraFR (Dec 8, 2005)

MT-That gave me some good reading. Are there any other links that anyone can provide?


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## monocyte (Jun 17, 2004)

Great thread.

I never thought about rhogam during pg (although I took it without thinking much...) and needed some extra as we had a bleed during delivery.

Having just had a miscarriage, I am wondering about my status now. Any thoughts on when a shot is necessary post mc?


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## japonica (May 26, 2005)

I recall being told to get a shot within within 72 hours of bleeding, trauma, amnio etc....not sure if that's correct though...

J


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## Momtezuma Tuatara (Mar 3, 2004)

Japonica is correct.


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## schatz (May 6, 2003)

Quote:

Fact. Rhogam antibodies cross the placenta and attack the baby's red blood cells
here's my anectdote to add -- my dd who is Rh+ was born with a very low red blood cell count -- they thought they would have to give her a transfusion. I had the 28-week rhogam shot. No proof but someone would be hard pressed to convince me that the rhogam shot did not cause my dd's low blood cell count. Yes, it could be from other factors although the docs could not give me an explanation of why it happened. I opted out of the 28-week shot with my son. He did not have the problems my dd had but he is also Rh- like me. So, had I gone ahead and had the 28 week shot with my son, would he not have had the low count because he is negative and therefore the antibodies would not have attacked his cells - not sure but the catch is that you don't know the status of the baby in-utero. If you read the Cochrane review, you'll see that the antenatal shot is given at varying times depending on the country (28 weeks, 34 weeks, both) and that it reduces the risk of sensitization by about 1% (from something like 1.3% to .3%). Thanks but no thanks - I'll take the postnatal shot IF I have an Rh+ baby. JMO.


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## amybw (Jul 12, 2004)

Thanks for this info! I have been contemplating it myself.









Amy


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## Amila (Apr 4, 2006)

I just wanted to give my two cents about Rhogam. I agonized over this for like _months_. What it came down to was:

1. I was not crazy about getting a human blood product, regardless of how "small" the risks of virus transmittance are. Judging from the government's definition of "small risks" regarding vaccines I don't put a lot of faith into the CDC.

2. I felt extremely uncomfortable putting anything into my body during pregnancy, given the possible future "unknown" problems that can result for a negative girl when she decides to have children. And the fact that there are some nasty chemicals in there. AND the fact that there have never been any studies done on the possible risks to the fetus, as Rhogam is a Class C drug: http://www.safefetus.com/DrugDetail....M&TradeId=4936

(When I brought this up to my doctor, he said "There are no risks- no one has ever reported any fetal problems as a result of Rhogam" to which I replied "But there have never been ANY studies done on this" to which he replied "Well how could there be?")









3. I believe it to be pretty unlikely that mom and baby's blood mixes in the course of a normal pregnancy free of trauma or intervention.

4. I read a fantastic book (and really the only one out there) by Sara Wickham called "Anti-D in Midwifery" It is extremely scientific, gives tons of info on the actual studies done to support Rhogam (they are pathetic, few and far between, and don't even follow the scientific method). I told myself I wouldn't make a final decision until I read this book (and I am glad I did).

http://www.amazon.com/gp/product/075...Fencoding=UTF8

So I declined the antenatal dose, and got a load of crap from the doctor (I have since switched). He said I was the only person in 12 years to decline, and that I was being ridiculous and foolish. When I started feeding him statistics, he laughed and told me I can't believe everything I read, and that those numbers seem "a bit off." That is when I pulled out the package insert:

http://www.orthoclinical.com/Product...1-20-971-3.pdf

where I got my info from and flung it in his face. He certainly shut up then!

What I gleaned from the insert was that without ANY rhogam, your risks of becoming sensitized are 12-13%. With ONLY the post-labor injection, your risks go down to 1-2%. With both antenatal AND post-labor, your risks are .1-.2%.

I plan to have my baby typed after she is born, and if she is positive, then I will go ahead and get the Rhogam. In my mind, at least I am doing it because I actually _know_ shes positive, I am only putting _myself_ at risk, and I am taking it with the knowledge that I might actually need it because the stats for blood mixing in labor are much more real than during pregnancy. Basically I am taking a 1-2% risk.

Also, I think it is important to note that I have fully come to the understanding in my own mind that if I _do_ become sensitized, then that is a consequence of my actions, and I still will not regret my decision. I don't feel that I can regret a decision of not potentially putting my beloved baby #1 at risk to save any future babies I _might_ have. Other women who desire to have large families might feel differently, and that is okay too. Anyway, I hope this helps someone who may be really on the fence. I find that doing my research from government documents that SUPPORT the drugs actually aid in my decision making process (ironic as that may be).


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## japonica (May 26, 2005)




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## Gitti (Dec 20, 2003)

Bumping for someone new.


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## illumini (Dec 2, 2006)

I know this is an old thread but I have a quick question concerning Rhogam. I have had 3 m/c's and a molar preganacy (no live babies as of now). In two of my m/c's I was not aware of my rh status and therefore did not get the shot. It was during my 3rd that I was tested and given the shot. I was also given the shot during my surgery for the molar. My doctor told me I needed to receive the shot early on in subsequent pregnancies in order to keep my body from rejecting the fetus. I never questioned him on _this_ (but I have on plenty of other things







) Do think it will be necessary to do the shot early and then again during birth? Thanks in advance! You ladies have really helped me gather information for my future children (and pregnancies).

Lauren


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## Spy (Aug 22, 2006)

Quote:


Originally Posted by *rozzie'sma* 
The US didn't used to do a prenatal Rhogam AT ALL. That didn't start till the 80's

I am curious what people used to do before any sort of Rhogam. Rh negative women are not exactly rare.


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## maxmama (May 5, 2006)

Quote:


Originally Posted by *Spy* 
I am curious what people used to do before any sort of Rhogam. Rh negative women are not exactly rare.

Before RhoGam was available, there was a strong possibility of an Rh-discordant couple having multiple miscarriages, stillbirths and neonatal deaths or disability due to hemolysis. There are a number of non-Rh blood groups for whom this is still the case, but because their numbers are much smaller, there is no prophylaxis available. As I mentioned before, Kell (for which I am negative, and my husband is homozygous positive) is one of the blood groups for which this is the case, and I feel very strongly about the risks of HDNB and the known benefits of RhoGam.


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## Peppermint (Feb 12, 2003)

: as I have few weeks to decide on this. I had the Rhogam during each of my other 3 pregnancies, and after my last pregnancy as he was my first + child. I a have c-section births, and during my last pregnancy had a "window" develop, I am concerned that I am at increased risk of blood mixing, but- then of course, concerned about what MT is saying about how the rhogam during pregnancy could actually attack the child I have in there now.







: I have lots of reading to do in the next few weeks, and will compile some for my Dr. to read between my 24 and 28 week visits. He is a reasonable man, and not at all the normal "head in the sand" type, so hopefully he will read what I give.


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## japonica (May 26, 2005)

Quote:

In two of my m/c's I was not aware of my rh status and therefore did not get the shot. It was during my 3rd that I was tested and given the shot.
I'm assuming they also tested your titre levels to see if you had developed anti-D antibodies from the first 2 m/c's or else why bother getting the shot for the third one?

Quote:

My doctor told me I needed to receive the shot early on in subsequent pregnancies in order to keep my body from rejecting the fetus.
That sounds off to me. From my understanding, it's intended for use after trauma or bleeding (if used at all in early pg) and is used by OBs in _late_ pg, around 28-30 weeks to prevent sensitization in the third tri and presumably at delivery. I've not heard of OBs using it routinely in early pg if there's no sign of bleeding. Strange.

Quote:

Do think it will be necessary to do the shot early and then again during birth?
No. Just my 2 cents, I would just wait until after birth, get tested, and then get the shot. But that's me. I experienced Rhogam failure (administered as it was supposed to be by health professionals), so I'm sceptical of its efficacy. Plus, now knowing what I do about how it works (and its ingredients), I would avoid it prenatally.

Quote:

Before RhoGam was available, there was a strong possibility of an Rh-discordant couple having multiple miscarriages, stillbirths and neonatal deaths or disability due to hemolysis. There are a number of non-Rh blood groups for whom this is still the case, but because their numbers are much smaller, there is no prophylaxis available. As I mentioned before, Kell (for which I am negative, and my husband is homozygous positive) is one of the blood groups for which this is the case, and I feel very strongly about the risks of HDNB and the known benefits of RhoGam.
Just my perspective, but I have my doubts about it. I've met a lot of women online who were given RhoGam as indicated, and still became sensitized. So, I question its efficacy...if the OBs and health professionals know what they're doing (and women are reporting to their OBs for the shot within that 72 hour window), why are so many women still getting sensitized? Having also come through one sensitized pg successfully and chatting with dozens of women online who have also had successful sensitized pgs (not intervention-free by any means though), becoming sensitized is not the worst case scenario that OBs and nurses make it out to be. Yes, it's no picnic to have IUTs or other interventions, but getting sensitized does not equal pg loss due to HDNB. Not one of the ladies I know on the iso board has had a loss from HDNB. Some are on their third iso pg. I just met with my OB this summer. My titres are up to 1:32 already before even TTCing a 3rd child, yet neither the OB nor peris recommended against it. They did not think it was a problem to proceed. I think responsible management of iso pgs by peris and MFMs makes a huge difference in outcomes.


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## rozzie'sma (Jul 6, 2005)

Quote:


Originally Posted by *Spy* 
I am curious what people used to do before any sort of Rhogam. Rh negative women are not exactly rare.


All I know about before Rhogam came from my grandmother. She had 4 boys, all Rh+, she is rh-. The first two boys were fine despite being "twilight births" She said how great it was, she went in they gassed and cut her and pulled them out with forceps, baby number 1 was breech too. So I am guessing from that the managment of the third stage was horrific. Baby three had jaundice but required no special treatments. Baby four had HDNB. He was a preemie and required 3 blood transfusions after birth, this was in the 50's but he lived. Basically what I am saying is that it wasn't a problem until it became a problem for the couple, then most of the time they just stopped having kids. My great grandma was rh- and had 6 babies at home UC, 4 rh+. She never had problems. Yes people have lost babies and it can be very serious, but it is not guaranteed.


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## iamleabee (Jul 28, 2005)

The only antibody to cross the placenta is IgG. This is what the immune system eventually makes after an exposure to antigen, so that a second exposure has a rapid immunilogical response.







:
RhoGam is an IgM anti-D immunoglobulin that binds to the D antigen and eliminates it from the body, thus preventing the maternal immune system from seeing it and forming IgG antibodies against it. The difference is that IgM antibodies are too large to cross the placental barrier, and therefore cannot harm the fetus (they contain 5 subunits), whereas IgG antbodies are small and do cross the placenta and attack fetal RBCs.








:


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## mamakay (Apr 8, 2005)

Quote:


Originally Posted by *iamleabee* 
The only antibody to cross the placenta is IgG. This is what the immune system eventually makes after an exposure to antigen, so that a second exposure has a rapid immunilogical response.







:
RhoGam is an IgM anti-D immunoglobulin that binds to the D antigen and eliminates it from the body, thus preventing the maternal immune system from seeing it and forming IgG antibodies against it. The difference is that IgM antibodies are too large to cross the placental barrier, and therefore cannot harm the fetus (they contain 5 subunits), whereas IgG antbodies are small and do cross the placenta and attack fetal RBCs.








:

Oooh...that makes sense.
I always thought RhoGam sounded a little counter intuitive. But I get it now. Thanks.


----------



## maxmama (May 5, 2006)

Quote:


Originally Posted by *iamleabee* 
The only antibody to cross the placenta is IgG. This is what the immune system eventually makes after an exposure to antigen, so that a second exposure has a rapid immunilogical response.







:
RhoGam is an IgM anti-D immunoglobulin that binds to the D antigen and eliminates it from the body, thus preventing the maternal immune system from seeing it and forming IgG antibodies against it. The difference is that IgM antibodies are too large to cross the placental barrier, and therefore cannot harm the fetus (they contain 5 subunits), whereas IgG antbodies are small and do cross the placenta and attack fetal RBCs.








:

Thank you for your explanation. All I could remember (pp brain) was that the IgM was too big to cross. Your explanation is much clearer!


----------



## rndasie (Dec 20, 2006)

Forgive me for coming in late and I haven't read all the posts, but I also understand that with the incompatibilty in rh factor that the antibodies of the mother can view the fetus as a predator and begin attacking it thus causing an abortion or premature labor. any bleeding during pregnancy will result in the mother receiving a RhoGam shot as the docs take that at some point the protective barriers may become compromised.

So my description of why you may receive a RhoGam may not be what you were looking for a may be a bit incorrect, as this only comes from what I was told by several OB's.


----------



## Peppermint (Feb 12, 2003)

Quote:


Originally Posted by *iamleabee* 
The only antibody to cross the placenta is IgG. This is what the immune system eventually makes after an exposure to antigen, so that a second exposure has a rapid immunilogical response.







:
RhoGam is an IgM anti-D immunoglobulin that binds to the D antigen and eliminates it from the body, thus preventing the maternal immune system from seeing it and forming IgG antibodies against it. The difference is that IgM antibodies are too large to cross the placental barrier, and therefore cannot harm the fetus (they contain 5 subunits), whereas IgG antbodies are small and do cross the placenta and attack fetal RBCs.








:

Don't duck, everyone here wants the TRUTH. That is what we do here. I was hoping you have a link or something to explain this, so I can really research it, only 4 weeks now until I am due for my injection. TIA!


----------



## wasabi (Oct 12, 2004)

Quote:


Originally Posted by *SaraFR* 
Is it just as effective to get no shot during the pg. but get one postpartum IF the baby ends up being pos.?

Yes it is.

They give us the shot at 28 weeks because the shot only lasts for 12 weeks and theoretically we're all going to give birth right smack on the dot at 40 weeks right?







The risks of a microbleed are very low and barring a major trauma or event there's no reason to think you're more likely to have a microbleed in the last 12 weeks of pregnancy than in the preceeding 28 weeks. There is also evidence that suggests that it would take 13 such microbleeds to actually build up enough sensitization as the major mixing that can occur during labor with modern birth practices. There's a really good website out there that lays a lot of this out but I don't have it saved any more because I've switched computers since I was making this decision last time. You might do a search for old threads about Rhogam. With my first three pgs I did have the prenatal shot and then for two pgs had the postpartum shot (DS was RH- as I knew he would be since his father was negative but hey they only had my word for it







). With the last pg I did my research and felt comfortable forgoing the prenatal shot. DD was born without incident and I had the postpartum shot. My feeling was that the postnatal shot only provided a risk to me whereas the prenatal shot was a risk to her. I felt better not risking the possibility of sensitization once she was out of me.


----------



## wasabi (Oct 12, 2004)

An older thread with good info though still not the link I was looking for.

http://www.mothering.com/discussions...14#post6907914


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## maxmama (May 5, 2006)

Quote:


Originally Posted by *wasabi* 
Yes it is.

No, it's not.

I was sensitized to Kell during my first pregnancy -- negative antibody screen at 6 weeks, positive at 28 weeks. No known trauma, no known placental bleeds. Frankly, I would take what I view to be the negligible risks of blood-borne pathogens related to RhoGam over sensitization.


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## wasabi (Oct 12, 2004)

I honestly don't know what Kell is but I do know a lot about Rh sensitivity. I have no idea if Kell sensitization is harder or easier to achieve during a normal pregnancy than RH sensitization. As I mentioned previously it is thought that it would take multiple microbleed to achieve actual RH sensitization I have no idea if the same is true for Kell. However if you were positive at 28 weeks and we subsitute RhoGam for Kell then you would still have been sensitized because you don't get the shot until 28 weeks. As I believe a previous poster mentioned your case actually proves the problem with the idea of giving the shot at 28 weeks preventing prenatal sensitization because you would have been sensitized before your prophalactic shot. There is a 1.8% chance of prenatal RH sensitization and that includes all women even those who were involved in severe traumas that put them squarely at risk for a microbleed. Again I have no idea what the risk is for Kell relative to the risk for prenatal RH sensitization. If I assume that it is similar to the risk of RH sensitization then you have to weigh whether or not being in that tiny tiny group (well less than 1.8%) is worth it or not. In my case I judged it was not worth it. In your case you're saying it would have been worth it. Just as in all cases where something is extremely low risk it doesn't matter if that .05% is you and I get that. But I think it is important to present facts about the risk and let people make their own judgements. In the *huge, vast* marjority of cases women who go through a normal pg with no spotting or trauma are just as well served getting a postnatal shot if the baby is positive.


----------



## wasabi (Oct 12, 2004)

I think this was the link I was thinking of.

http://www.*********/a/rhogam.html

And this one:

http://www.gentlebirth.org/archives/...re.html#RhoGAM


----------



## maxmama (May 5, 2006)

Quote:


Originally Posted by *wasabi* 
I honestly don't know what Kell is but I do know a lot about Rh sensitivity. I have no idea if Kell sensitization is harder or easier to achieve during a normal pregnancy than RH sensitization. As I mentioned previously it is thought that it would take multiple microbleed to achieve actual RH sensitization I have no idea if the same is true for Kell. However if you were positive at 28 weeks and we subsitute RhoGam for Kell then you would still have been sensitized because you don't get the shot until 28 weeks. As I believe a previous poster mentioned your case actually proves the problem with the idea of giving the shot at 28 weeks preventing prenatal sensitization because you would have been sensitized before your prophalactic shot. There is a 1.8% chance of prenatal RH sensitization and that includes all women even those who were involved in severe traumas that put them squarely at risk for a microbleed. Again I have no idea what the risk is for Kell relative to the risk for prenatal RH sensitization. If I assume that it is similar to the risk of RH sensitization then you have to weigh whether or not being in that tiny tiny group (well less than 1.8%) is worth it or not. In my case I judged it was not worth it. In your case you're saying it would have been worth it. Just as in all cases where something is extremely low risk it doesn't matter if that .05% is you and I get that. But I think it is important to present facts about the risk and let people make their own judgements. In the *huge, vast* marjority of cases women who go through a normal pg with no spotting or trauma are just as well served getting a postnatal shot if the baby is positive.

My point is that I disagree with a categorical argument against antenatal RhoGam. My "28 week" labs were actually probably 30 week labs, based on how my 36 weeker looked when born. The argument for using antenatal RhoGam at 28 weeks is that with *most* pregnancies, there isn't enough volume of fetal blood to sensitize if there is a silent (not necessarily micro) bleed until *approximately* 28 weeks. Obviously, YMMV.


----------



## theretohere (Nov 4, 2005)

Someone mentioned a risk to + baby girls later- is there any information out there about this?


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## SuperMoM2GTO (Dec 13, 2006)

I had the rhogam shot @ 28 weeks and* after birth... Is my son at risk now that I did??? I had NO idea rhogam was the blood of other people :yuck: Should I get tested for HIV?


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## AmieV (Mar 31, 2005)

I would not worry about HIV from a rhogam shot. They screen blood products very carefully.

What you can worry about if you're looking for something...is the viruses we don't know about. there's no telling how many hepatitis viruses there truly are.

I hadn't read all the information here, but there were some stats in Ina May's book that convinced me the antenatal shot was worthwhile. My m/w uses Rophylac? or something that I always spell wrong that is cleaner as far as preservatives go. The effects of sensitization were just so devastating that the risk/benefit ratio for me personally worked its way out into me getting the shot. I didn't have MT's info though...but honestly I didn't read it more than once and I don't really understand it.







and what's done is done so I'm just going to go to bed instead.

I've had 3 doses of rhogam...one after my m/c and one during both pg's. And it was all for naught...both my girls are RH negative and oh goody, get to research this issue when they get old enough to have babies!

the one bizarre thing is that my m/w offered it to me after knowing dd2 was negative. She said some people feel like you can still sensitize, especially the more pg's you have. This made absolutely no sense to me, and it was weird because she's anti all the other vaxes. I didn't question her a lot on it because this is my last baby anyway, and it was 2 days post partum so I wasn't up for discussing stuff like that.

I had no idea it was a blood product the first time I had it either. Nice "informed consent", huh?


----------



## SaraFR (Dec 8, 2005)

I also never knew it was a blood product.


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## japonica (May 26, 2005)

Yup, it is.

From http://www.rhogam.com/English/Profes...rofRhogam.aspx

Quote:

RhoGAM® and MICRhoGAM® Ultra-Filtered are made from human plasma. Because these products are made from human blood, they may carry a risk of transmitting infectious agents, e.g., viruses, and theoretically the Creutzfeldt-Jakob disease (CJD) agent.


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## SaraFR (Dec 8, 2005)

Quote:


Originally Posted by *japonica* 
Yup, it is.

From http://www.rhogam.com/English/Profes...rofRhogam.aspx

Not reassuring for those of us who have had it (twice) before knowing.


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## maxmama (May 5, 2006)

Quote:


Originally Posted by *SaraFR* 
Not reassuring for those of us who have had it (twice) before knowing.


i've had ten doses plus been transfused twice, and I'm not worried.


----------



## mamakay (Apr 8, 2005)

Quote:


Originally Posted by *maxmama* 
i've had ten doses plus been transfused twice, and I'm not worried.

Er, so have you ever read about the problem of adventitious agents in biologicals?

If so, what are your thoughts?


----------



## Peppermint (Feb 12, 2003)

Quote:


Originally Posted by *iamleabee* 
The only antibody to cross the placenta is IgG. This is what the immune system eventually makes after an exposure to antigen, so that a second exposure has a rapid immunilogical response.







:
RhoGam is an IgM anti-D immunoglobulin that binds to the D antigen and eliminates it from the body, thus preventing the maternal immune system from seeing it and forming IgG antibodies against it. The difference is that IgM antibodies are too large to cross the placental barrier, and therefore cannot harm the fetus (they contain 5 subunits), whereas IgG antbodies are small and do cross the placenta and attack fetal RBCs.








:

I already quoted this and asked for some references for this, and perhaps I am being impatient, but I would really like to hear more on this assertion, from either side, preferrably both sides. Thanks!


----------



## mamakay (Apr 8, 2005)

Quote:


Originally Posted by *Peppermint* 
I already quoted this and asked for some references for this, and perhaps I am being impatient, but I would really like to hear more on this assertion, from either side, preferrably both sides. Thanks!

I'm meaning this in a very _un_snarky way...(seriously)...
But you can look the information up yourself at this point.


----------



## Peppermint (Feb 12, 2003)

OK, here is what I find: (with a quick search)
http://www.madsci.org/posts/archives...8607.Me.r.html

http://www.path.sunysb.edu/coursemat...odlymphoid.htm

http://www.mfi.ku.dk/ppaulev/chapter32/kap32.htm

which all seem to agree with what I quoted, that the IgM *is* too big to cross the placenta. My issues are 2- I find MT to be very well-researched, and generally don't find her spouting things that aren't true, which leads me to the second part being, I don't know how to research this as well as I should, I suppose. All I can do is search google and see what comes up, I have found that I miss a lot when I try to look into things myself, and in the past others on this forum seem to be able to find the "other side" easier and help me see what I am missing.

I am simply a few weeks from having this injection again, and want to make the right choice. I am not having a "normal healthy pregnancy and intervention-free birth" so it really is more of an issue for me. One of the most convincing things I saw which made me re-think getting the shot, was the idea that it could hurt this baby, the one I am carrying *right now*, HE is my main concern, and I want to see him born healthy, and have a lot to consider with that.

This seems so different from all of the vaccines we discuss here, which, for me, have been easily proven not only harmful, but ineffective and unnecessary. I am feeling like this is not so cut and dry, at least for someone without a "healthy pregnancy and natural birth".


----------



## mamakay (Apr 8, 2005)

Quote:


Originally Posted by *Peppermint* 
OK, here is what I find: (with a quick search)
http://www.madsci.org/posts/archives...8607.Me.r.html

http://www.path.sunysb.edu/coursemat...odlymphoid.htm

http://www.mfi.ku.dk/ppaulev/chapter32/kap32.htm

which all seem to agree with what I quoted, that the IgM *is* too big to cross the placenta. My issues are 2- I find MT to be very well-researched, and generally don't find her spouting things that aren't true, which leads me to the second part being, I don't know how to research this as well as I should, I suppose. All I can do is search google and see what comes up, I have found that I miss a lot when I try to look into things myself, and in the past others on this forum seem to be able to find the "other side" easier and help me see what I am missing.

I am simply a few weeks from having this injection again, and want to make the right choice. I am not having a "normal healthy pregnancy and intervention-free birth" so it really is more of an issue for me. One of the most convincing things I saw which made me re-think getting the shot, was the idea that it could hurt this baby, the one I am carrying *right now*, HE is my main concern, and I want to see him born healthy, and have a lot to consider with that.

This seems so different from all of the vaccines we discuss here, which, for me, have been easily proven not only harmful, but ineffective and unnecessary. I am feeling like this is not so cut and dry, at least for someone without a "healthy pregnancy and natural birth".

I gotcha.
MT is usually correct, but everyone makes mistakes sometimes.
I'm pretty good at "debunking" stuff...







: ...so I'll see if I can help you out. Give me a few days to see if there's "another side" out there.

I have an immunologist friend who's sort of antivax, too, and I'll ask her if she knows what the deal is.









I'm Rh- myself, but only plan on having my one child I have, so I've never really looked at the issue that deeply before.


----------



## maxmama (May 5, 2006)

Quote:


Originally Posted by *mamakay* 
Er, so have you ever read about the problem of adventitious agents in biologicals?

If so, what are your thoughts?

There's risk/benefit, like literally everything else. I'm more concerned about the known risks to, say, going into cardiac failure from a hct of 18 than I am about possible risks from transfusion. Ditto for RhoGam.


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## Plummeting (Dec 2, 2004)

Quote:


Originally Posted by *iamleabee* 
The only antibody to cross the placenta is IgG. This is what the immune system eventually makes after an exposure to antigen, so that a second exposure has a rapid immunilogical response.







:
RhoGam is an IgM anti-D immunoglobulin that binds to the D antigen and eliminates it from the body, thus preventing the maternal immune system from seeing it and forming IgG antibodies against it. The difference is that IgM antibodies are too large to cross the placental barrier, and therefore cannot harm the fetus (they contain 5 subunits), whereas IgG antbodies are small and do cross the placenta and attack fetal RBCs.








:


IgM doesn't cross the placenta, right. But can you show me where you learned that RhoGam is IgM? I can't find any evidence to support that assertion.


----------



## alegna (Jan 14, 2003)

Quote:


Originally Posted by *iamleabee* 
The only antibody to cross the placenta is IgG. This is what the immune system eventually makes after an exposure to antigen, so that a second exposure has a rapid immunilogical response.







:
RhoGam is an IgM anti-D immunoglobulin that binds to the D antigen and eliminates it from the body, thus preventing the maternal immune system from seeing it and forming IgG antibodies against it. The difference is that IgM antibodies are too large to cross the placental barrier, and therefore cannot harm the fetus (they contain 5 subunits), whereas IgG antbodies are small and do cross the placenta and attack fetal RBCs.








:


This:
http://www.rxlist.com/cgi/generic2/rhogam.htm

says that rhogam is IgG. Is there something I'm missing?

-Angela


----------



## NinaBruja (Jan 19, 2004)

Quote:


Originally Posted by *iamleabee* 
The only antibody to cross the placenta is IgG. This is what the immune system eventually makes after an exposure to antigen, so that a second exposure has a rapid immunilogical response.







:
RhoGam is an IgM anti-D immunoglobulin that binds to the D antigen and eliminates it from the body, thus preventing the maternal immune system from seeing it and forming IgG antibodies against it. The difference is that IgM antibodies are too large to cross the placental barrier, and therefore cannot harm the fetus (they contain 5 subunits), whereas IgG antbodies are small and do cross the placenta and attack fetal RBCs.








:

this is what my friend told me:

Rhogam is IgG.
http://www.rxlist.com/cgi/generic2/rhogam.htm

eta: crosspost!


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## alegna (Jan 14, 2003)

Great crossposting batman! Way to google the same link too!

-Angela


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## mamakay (Apr 8, 2005)

Quote:


Originally Posted by *maxmama* 
There's risk/benefit, like literally everything else. I'm more concerned about the known risks to, say, going into cardiac failure from a hct of 18 than I am about possible risks from transfusion. Ditto for RhoGam.

So that part where they talk about covering up the "rather large number" of cases of contamination doesn't make you wonder what the actual risk/benefit ratio might be?
He even used the words "sooner or later the information will *leak out*".

I'm not generally one for conspiracy theories, but dang!
I mean, that's pretty darn bad.

In your mind, as long as the risk part is _actively concealed_ from the public, it's just a "_possible risk_"? As opposed to a "known risk"?










I guess that's what they're going for...


----------



## Peppermint (Feb 12, 2003)

Geesh, you see what I mean? I don't even know what to look for! I *assumed* it was true that RhoGam was the IgM. Therefore everything I searched was assuming the same. Now, I read back through my links and see that they all say something along the lines of "Most antibodies against A and B antigens are of the IgM type" *MOST* being the operative word, and clearly, RhoGam is not, according to your link. It makes me mad, b/c the first 2 links *clearly* make it sound as though RhoGam is IgM. The lies make me angry.







:


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## Plummeting (Dec 2, 2004)

Peppermint, the way it was explained to me is that it would be impossible to even find IgM antibodies for this purpose, because IgM antibodies are made for the short term - as soon as the exposure happens. They're made long enough to allow the body time to start manufacturing IgG. Since RhoGam is a blood product, made from women who have experienced Rh sensitization already, if they wanted the product to be IgM, they'd have to collect it immediately after sensitization occurred, so there would still actually be measurable IgM antibodies in there. Then they'd have to figure out a way to remove all the IgG that had already been created. It would not be feasible at all - how would they know exactly when a woman had been sensitized???


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## iamleabee (Jul 28, 2005)

i am researching to find out if my understanding was wrong. it might take me a few days to get back to you, but i'll post if i realize my understanding was flawed or if i think it was correct.
meanwhile i found some interesting articles.

this one deals with the number of silent FMH, which was discussed earlier in this thread:

http://www.thomsonhc.com/hcs/librari...d/31#secN67850

_Quote removed as it exceeded the 100 words or less allowed by MDC's Copyright Policy_
this article discusses when/how/quantity of anti-D to prevent sensitization:

http://www.ncbi.nlm.nih.gov/entrez/q...=pubmed_docsum

"Efficacy of prophylaxis relies also on the delay between the sensitizing event and the injection of anti-D, delay should be less than 72 hours. Intravenous administration of anti-D allows immediate neutralization of D positive fetal red blood cells and should be, if possible, preferred to intramuscular administration (IM). After a first injection of anti-D, if repetition of potential sensitizing events occurs, abstention of prophylaxis is possible depending on the previous administrated dose (protection lasts 6 weeks for 200microg and 9 weeks for 300microg) and the amount of feto-maternal hemorrhage. "

this article looked at 6 Rh studies to date (2000):

http://www.ncbi.nlm.nih.gov/entrez/q...=pubmed_docsum
_Quote removed as it exceeded the 100 words or less allowed by MDC's Copyright Policy_

finally, this one looked at failure of prophylaxis to occur:
http://www.ncbi.nlm.nih.gov/entrez/q...=pubmed_docsum

Rh immunization, despite universal Rh prophylaxis, developed in 25 women; eight before antenatal prophylaxis was administered, 17 after antenatal prophylaxis was administered. Residual Rh immunization is caused by small fetal transplacental hemorrhages (TPH) (greater than or equal to 0.01 mL of fetal blood) before antenatal prophylaxis (15%) and by significant fetal TPH (greater than or equal to 0.05 mL of fetal blood) between 30 and 38 weeks' gestation (18%); TPH was too great, in some instances, for residual passive Rh antibody to give protection.


----------



## Peppermint (Feb 12, 2003)

Quote:


Originally Posted by *iamleabee* 
i am researching to find out if my understanding was wrong. it might take me a few days to get back to you, but i'll post if i realize my understanding was flawed or if i think it was correct.
meanwhile i found some interesting articles.


Thank you for the articles, I am off to read them, but in the meantime, wanted to see if you had read this link posted above:
Rhogam is IgG.
http://www.rxlist.com/cgi/generic2/rhogam.htm

It seems pretty non-disputable to me.


----------



## Plummeting (Dec 2, 2004)

Quote:


Originally Posted by *Peppermint* 
Thank you for the articles, I am off to read them, but in the meantime, wanted to see if you had read this link posted above:
Rhogam is IgG.
http://www.rxlist.com/cgi/generic2/rhogam.htm

It seems pretty non-disputable to me.


Yes, iamleabee. I'm really not sure how you can dispute the description of the drug. What I think you should consider is who gave you the information you gave us, because henceforth, I would no longer trust that person or entity as a reliable source. Either they lie or they are grossly misinformed. Regardless, they're unreliable and you shouldn't trust anything else you learn from this source until you verify it independently. We can all see the information was incorrect without you verifying that fact for us.


----------



## Peppermint (Feb 12, 2003)

Clearly though, this is something that is being "taught" as truth to more than just iamleabee, I found lots of sources saying the same thing. The lies run deep and I wonder what the purpose is?


----------



## Plummeting (Dec 2, 2004)

Quote:


Originally Posted by *Peppermint* 
Clearly though, this is something that is being "taught" as truth to more than just iamleabee, I found lots of sources saying the same thing. The lies run deep and I wonder what the purpose is?

What sources did you read that specifically said RhoGam was IgM?


----------



## Peppermint (Feb 12, 2003)

Quote:


Originally Posted by *Peppermint* 
OK, here is what I find: (with a quick search)
http://www.madsci.org/posts/archives...8607.Me.r.html

http://www.path.sunysb.edu/coursemat...odlymphoid.htm

http://www.mfi.ku.dk/ppaulev/chapter32/kap32.htm

which all seem to agree with what I quoted, that the IgM *is* too big to cross the placenta. My issues are 2- I find MT to be very well-researched, and generally don't find her spouting things that aren't true, which leads me to the second part being, I don't know how to research this as well as I should, I suppose. All I can do is search google and see what comes up, I have found that I miss a lot when I try to look into things myself, and in the past others on this forum seem to be able to find the "other side" easier and help me see what I am missing.

I am simply a few weeks from having this injection again, and want to make the right choice. I am not having a "normal healthy pregnancy and intervention-free birth" so it really is more of an issue for me. One of the most convincing things I saw which made me re-think getting the shot, was the idea that it could hurt this baby, the one I am carrying *right now*, HE is my main concern, and I want to see him born healthy, and have a lot to consider with that.

This seems so different from all of the vaccines we discuss here, which, for me, have been easily proven not only harmful, but ineffective and unnecessary. I am feeling like this is not so cut and dry, at least for someone without a "healthy pregnancy and natural birth".

The first 2 links I posted in this post said it. Well, as I say, it was *implied* I suppose, with careful wording. They say "most" and then go on to presume RhoGam is IgM.


----------



## roxyrox (Sep 11, 2006)

I am just posting to say that my mother was rh- and never once had anti-D. She had 5 pregnacies and never had anti-D and had no problems. She has 3 negative babies and 2 positive ones, all in different orders. It is the boys that are + so I am not sure if that makes a difference but I think someone mentioned it may earlier. ( She had G,B,B,B,G in that order) I am RH- as well and refused it during pregnancy (although I may have had if if it turned out my ds was + although he was not). I just really don't understand the theory behind getting in it pregnancy. To me it didn't make sense which is why I refused.


----------



## Plummeting (Dec 2, 2004)

Quote:


Originally Posted by *Peppermint* 
The first 2 links I posted in this post said it. Well, as I say, it was *implied* I suppose, with careful wording. They say "most" and then go on to presume RhoGam is IgM.

I didn't find them misleading at all, actually. The first link specifically says:

Quote:

Anti-Rh antibodies of the IgG subclass readily cross the placenta and can destroy the fetal red cells.
so I don't see how they're implying that anti-rh antibodies are IgM, since it _says_ they're IgG. Since RhoGam is anti-rh antibodies, I don't see why they'd need to explain it in more detail. The only reason it discusses IgM antibodies is because the whole point of the page is to answer the question of why blood group antibodies don't kill the fetus. Since blood group antibodies are IgM, it's only appropriate to discuss IgM. In fact, IMO, it wouldn't even have been necessary to discuss the whole anti-rh antibodies, since that wasn't part of the question.

The second link only discusses administering RhoGam after birth, miscarriage or abortion. They never even mention administering it during pregnancy, so I don't really see why they would consider it relevant that RhoGam-derived IgG can cross the placenta, since they aren't advocating its use during pregnancy, but _after_. In fact, this sentence:

Quote:

The RhoGAM antibodies themselves do not persist for long in the mother's circulation and so do not pose a threat to future pregnancies.
suggests to me that they assume readers are aware that RhoGam antibodies pose a potential threat to the fetus.

You'll have to tell me where to look in the third link. I did see mention that IgM doesn't cross the placenta, whereas IgG does, but I did not see any discussion of how that relates to RhoGam.


----------



## Peppermint (Feb 12, 2003)

I guess I don't have a very good eye for this stuff, what I saw was (on the first 2 pages, again, I didn't say the third link discussed RhoGam, just that it said IgM doesn't cross the placenta) an implication that IgG was the result of being sensitized, but that IgM was the result of RhoGam, implying that that was why RhoGam should be used.







: But- I have admitted already that I am not the brightest one around here in reading these things, so I must've taken it wrong.


----------



## Plummeting (Dec 2, 2004)

Quote:


Originally Posted by *Peppermint* 
I guess I don't have a very good eye for this stuff, what I saw was (on the first 2 pages, again, I didn't say the third link discussed RhoGam, just that it said IgM doesn't cross the placenta) an implication that IgG was the result of being sensitized, but that IgM was the result of RhoGam, implying that that was why RhoGam should be used.







: But- I have admitted already that I am not the brightest one around here in reading these things, so I must've taken it wrong.

Heheheh! Everybody misses things sometimes. See how I very clearly missed you saying it was only the first two links?


----------



## mamakay (Apr 8, 2005)

It's also never a bad idea to consult "evidence based medicine" when trying to figure stuff like this out.









http://www.cochrane.org/reviews/en/ab000020.html

That's a .8% difference.

http://www.cochrane.org/reviews/en/ab000021.html

Still not a huge difference, but better than less than 1%.

I loves me some Cochrane Collaboration.
See what actually works not only in theory, but in practice. What a brilliant idea!


----------



## Peppermint (Feb 12, 2003)

Plummeting- I figure I will get better at these things if I keep hanging out here







.

Mamakay, thank you for those links. I really hope my OB will consider this with me, and I won't have to deal with "we will kick you out of our care if you refuse this".


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## iamleabee (Jul 28, 2005)

I was wrong. thank you for pointing this out to me. Rhogam is pooled IgG.

Based on *my* understanding and the studies I've read (some of which are posted above), I believe it is worth taking this shot. Overall, it
stops the immune system from mounting a response, which would be a lot worse since the activated lymphocyte would clonally proliferate and release a lot more antibody than what is administered in RhoGam. With the shot, the idea is only a small amount of Ab is needed to neutralize a small amount of Ag and shield it from the immune system. The amount that might cross through the placenta is inadequate to cause damage to the fetus based on the clinical trials, some of which I listed above, I can make a list of more if people are interested.. Serious adverse reactions are rare: from 1990 to 2000, during which time 2.9 million doses of one manufacturer's anti-D immune globulin were given, the
manufacturer received only 11 reports of adverse events possibly
related to the drug. Now, maybe it's possible that there were more adverse reactions than what was reported, I don't know.


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## iamleabee (Jul 28, 2005)

these are some of the articles i looked at:
(search terms: RhoGam, pregnancy, adverse events, fetal anemia, isoimmunization)

http://www.sciencedirect.com/science...062e318453928f
_Quotes edited as they violate MDC's copyright policy_

http://www.sciencedirect.com/science...cbb5308451844f
_Quotes edited as they violate MDC's copyright policy_

http://www.sciencedirect.com/science...2ad1b01b944600
_Quotes edited as they violate MDC's copyright policy_

http://www.ncbi.nlm.nih.gov/entrez/q...=pubmed_docsum
_Quotes edited as they violate MDC's copyright policy_

http://www.ncbi.nlm.nih.gov/entrez/q...=pubmed_docsum
_Quotes edited as they violate MDC's copyright policy_

http://www.ncbi.nlm.nih.gov/entrez/q...=pubmed_docsum
_Quotes edited as they violate MDC's copyright policy_


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## Plummeting (Dec 2, 2004)

Quote:


Originally Posted by *iamleabee* 
Based on *my* understanding and the studies I've read (some of which are posted above), I believe it is worth taking this shot. Overall, it stops the immune system from mounting a response, which would be a lot worse since the activated lymphocyte would clonally proliferate and release a lot more antibody than what is administered in RhoGam. With the shot, the idea is only a small amount of Ab is needed to neutralize a small amount of Ag and shield it from the immune system.

First, when one chooses to accept RhoGam while still pregnant, they are without a doubt subjecting their child to antibodies that will cross the placenta and will do some damage - it's the amount of damage that's in question, not whether or not it actually happens. Anti-Rh antibodies destroy fetal blood cells in the spleen. Period. BUT, if one delays RhoGam until after delivery, there is only a slight, slight chance that their child will be exposed to the antibodies. So, a woman has to decide: If I choose to use RhoGam while pregnant, is the minimal possible benefit (see the Cochrane review) worth the 100% assurance that my child will be exposed to antibodies that will destroy some of his/her blood cells? I think RhoGam after delivery can be a good idea, but RhoGam before delivery in a perfectly normal, healthy pregnancy doesn't make sense.

Second, there are _always_ more adverse reactions than are reported. I think that's a given with all drugs, all the time. I 100% believe, and I think _most_ people in _this_ forum will agree, that clinical trials always understate the risk. They find multiple ways to do this, but they always do it. Believe otherwise if you want, but then we can point you in the direction of information on the SSRI/suicidal ideation links and the Vioxx/heart problem links. Pharmaceutical companies have a long, long, long history of manipulating studies every way they can to make their products look more beneficial and less harmful than they actually are. In reality, they have an imperative to do whatever they legally can to make money for their shareholders. Unfortunately, cheating has been paying off for them. Until the government starts cracking down on that (yeah, don't hold your breath) it will continue to be profitable for them and they will continue to do it.

Editing because you were talking about reported adverse reactions. Of course we can assume there were more adverse reactions that were not reported, as well. Doctors consistently refuse to believe that problems are related to any particular drug or treatment that was given. I developed severe chest pain, difficulty breathing and greying of my vision while on medication as a teenager. The doctor told me it was in my head and I was having panic attacks, until I lucked out and it happened while I happened to be in a hospital one day. A nurse took my bp and it was through the roof - like to the point that they thought I was about to DIE. I had been experiencing that a couple times a day for over a month, but had been blown off by the doctor several times a week since the time I first told him. I guess if I hadn't been in the hospital that day, it would've continued until maybe I just died. Then what? I guess they would've said that I just had a weak heart all along and no one noticed it. This isn't uncommon. It happens all the time.


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## mamakay (Apr 8, 2005)

Quote:


Originally Posted by *iamleabee* 
I was wrong. thank you for pointing this out to me. Rhogam is pooled IgG.

Based on *my* understanding and the studies I've read (some of which are posted above), I believe it is worth taking this shot. Overall, it
stops the immune system from mounting a response, which would be a lot worse since the activated lymphocyte would clonally proliferate and release a lot more antibody than what is administered in RhoGam. With the shot, the idea is only a small amount of Ab is needed to neutralize a small amount of Ag and shield it from the immune system. The amount that might cross through the placenta is inadequate to cause damage to the fetus based on the clinical trials, some of which I listed above, I can make a list of more if people are interested.. Serious adverse reactions are rare: from 1990 to 2000, during which time 2.9 million doses of one manufacturer's anti-D immune globulin were given, the
manufacturer received only 11 reports of adverse events possibly
related to the drug. Now, maybe it's possible that there were more adverse reactions than what was reported, I don't know.

So, the risk difference between getting the shot and not getting the shot during pregnancy is .8%, right?
The risk is 1% of you don't get it, and it's .2% if you get it.


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## oneKnight (Aug 4, 2006)

I've heard numerous accounts of women testing different for rH same woman testing both + and - so I'm not so sure they even can tell which you are. I read up on it a while back. My mom told me that I am rH- from the test they did when I was a newborn. Maybe I am, maybe I'm not. Maybe I've "changed" over the years. I am not planning to get the shot unless something goes terribly wrong.

Here are a couple of the links I used, but it's been a long time since I've read them.
http://www.thebirthsource.homestead.com/rh.html

Rhogam Insert pdf

old MDC thread


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## mimiharshe (Oct 16, 2006)

i haven't read through all of this yet, but i'm going to b/c i had the shots w/both dc both times "just to be safe", now i'm wondering if i should just do the one after IF baby is +. anywho, should we do a poll (maybe a new thread to get ppl to click on it) to see how many get the shot both times, just after or not at all???? that'd be interesting to see!


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## User101 (Mar 3, 2002)

I've read this whole thread








and learned a lot of new things. However, it's really outside the scope of the Vaccination forum since it deals more with the efficacy and necessity of the shot before, during, and after birth rather than issues it might hold in common with other Vaccination discussions (mercury as a preservative, for example.) Therefore, I'm bumping you over to Birth and Beyond.


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## St. Margaret (May 19, 2006)

Thank you AnnetteMarie for moving this here, b/c I am RH- and I don't really visit the Vax forum that much yet, and I am jut about at the point where I "need" to get the first shot... I am going to read through this thread more thoroughly for sure!!! And thanks to those who have posted b/c I knew very little about this...


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## japonica (May 26, 2005)

Quote:

should we do a poll (maybe a new thread to get ppl to click on it) to see how many get the shot both times, just after or not at all????
Knowing what I do now (and hindsight is 20/20) I would NOT get the shot until after my child was born and tested Rh positive, and only then after some serious consideration. I had 3 shots of winrho during my first pg, all given by "competent" medical professionals. I was sensitized anyway. And I lost my first child at 40 weeks for unknown reasons (pathology tests showed a number of curious things happened including a massive inflammation of the placenta for again, unknown causes). I did go through a second pg (this one a sensitized one) and delivered a healthy (albeit slightly jaundiced) baby. I know sensitization is not desirable but it is also not the end of childbearing if it takes place. So, just my 2 cents but if I were to do it all again, knowing about how rhogam functions (the IgG) and its components (based upon the human plasma and possible infectious agents), I'd be more cautious about agreeing so readily to the shots.


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## wasabi (Oct 12, 2004)

Quote:


Originally Posted by *AmieV* 
I had no idea it was a blood product the first time I had it either. Nice "informed consent", huh?

I had had six shots of it before I knew.


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## homebirthbaby (Aug 10, 2006)

Is it possible to have a + baby if both parents are -?


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## colobus237 (Feb 2, 2004)

Asked a dr. about this just today as I was curious - that the anti-D is recommended here during pregnancy, but isn't it a bad thing to have anti-D antibodies and an Rh+ baby inside?
Her answer was that the amount given is enough to talk one's body out of producing its own antibodies, but not enough to cause significant hemolysis in the baby at all. Further explained that Rh- people can be transfused with Rh+ blood as long as it is an acceptable proportion of total blood volume, and that even isoimmunized mothers do not always produce enough antibodies to cause problems with an Rh+ baby - this is why an isoimmunized person would have no treatment as long as titers were okay.

And last of all, I believe anti-D is made from the blood of deliberately Rh-sensitized males, not from accidentally sensitized women.

Editing to add: no, being neg. is recessive in my understanding, so two Rh- parents shouldn't be able to produce an Rh+ offspring. But something is telling me there may be more to it than that and I can't remember what...real helpful, right?


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## wasabi (Oct 12, 2004)

Quote:


Originally Posted by *homebirthbaby* 
Is it possible to have a + baby if both parents are -?

I did not think it was but over many discussions of Rhogam and RH status apparently it is possible although rare.


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## St. Margaret (May 19, 2006)

Okay so I have read the whole thread at last and this is where I currently am:







: More from my own mental sluggishness in trying to understand these different scientific terms and conditions than anything-- I feel like I'm rereading a difficult passage of my college science textbook,







. I guess I have a lot more careful reading to do to decide about this.

My mom keeps telling me to double check b/c she's RH- but has the Du/ffy factor, so it was never an issue for her. I would NOT put it past my old OB's office to have completely missed this point. Also, I have GOT to get heel-dragging DH to finally get his stupid blood type from his old doctor or get tested, so we know where we stand!

Thanks so much to those who have posted here-- I've learned so much already about this thing I didn't understand at all (beyond what the drug co pamphlet-- not insert, just propaganda papers--told me).


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## ~Heyokha~ (Nov 21, 2006)

Quote:


Originally Posted by *homebirthbaby* 
Is it possible to have a + baby if both parents are -?

my MW gave me this link when I asked the same question

http://www.thetech.org/genetics/ask.php?id=114


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## BurgundyElephant (Feb 17, 2006)

bump


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## BrooklynDoula (Oct 23, 2002)

Quote:


Originally Posted by *Spy* 
I am curious what people used to do before any sort of Rhogam. Rh negative women are not exactly rare.

True and before Rhogam, their babies died. My greeat aunt had this. One baby who was largely healthy, one still birth, 3 mischarages, 2 more still births, one healthy baby, 4 miscarriages. She also needed a blood transfusion after an accident and almost died.

I had two doses with ds (0+) and I will have a dose at 28 weeks (2 more weeks).


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## wannabe (Jul 4, 2005)

Quote:


Originally Posted by *trini* 
Can I jump on this thread and ask a related question?

Is it necessary to do it during the pg AND at delivery? Would it be effective to just do it at delivery, therefore preventing it from affecting the baby in any way?

Routine immunisation during pregnancy reduces the rate from around 1.5% to around 0.7%. This is even with immunisation after bleeds/trauma. The theory is that micro bleeds cause sensitisation and no-one is any the wiser.

Routiine prenatal Rhogam jabs were started in the UK. The NHS is reknowned for thorough cost-benefit analyses. No "wow, the drug companies are sellign something, it must be useful" from them. And Rhogam is in drastically short supply, due to the difficulty in finding sensitised people these days. There's hardly a need to drum up business.

It IS a nasty jab, in that its derived from human blood products, but it's necessary. I had it.

And I'm another example of immunisation during pregnancy. At birth of my first pregnancy, with no known bleeds, my baby had anti-A antibodies from me. I was sensitised to her blood with absolutely no symptoms. Luckily we're both Rh- (ABO sensitisation is less serious).


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## CalebsMama05 (Nov 26, 2005)

Quote:


Originally Posted by *wannabe* 
Routiine prenatal Rhogam jabs were started in the UK.

i'm not rh- but my friend is which is why I clicked this thread...and I thought I read earlier in the thread that the UK DOESN'T do antenatal Rhogam shots?


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## oneKnight (Aug 4, 2006)

Quote:


Originally Posted by *MSAX* 
True and before Rhogam, their babies died.

If Rh- women are so common, then it seems like it would've affected the population more over the years of evolution. If all their babies died . . . non-reproducing individuals get bred out because their genes aren't reproduced to the next generation. Maybe it's still around because it's recessive, but it still seems rather odd that the shot hasn't been around that long but Rh- women and their kids have been around evolving for years.
Sorry I guess I'm just rambling. I really don't believe the shot is necessary.


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## BrooklynDoula (Oct 23, 2002)

Quote:


Originally Posted by *oneKnight* 
If Rh- women are so common, then it seems like it would've affected the population more over the years of evolution. If all their babies died . . . non-reproducing individuals get bred out because their genes aren't reproduced to the next generation. Maybe it's still around because it's recessive, but it still seems rather odd that the shot hasn't been around that long but Rh- women and their kids have been around evolving for years.
Sorry I guess I'm just rambling. I really don't believe the shot is necessary.

What you are saying it only partially true, though. The issue is not Rh- women per se ONLY Rh- women who have Rh+ partners and only when they produce an Rh+ baby. Rh- is not nearly as common as Rh+ and it varies among populations (such that historically in a group with high Rh- you would also have a height change of having an Rh- breeding partner and in groups with low rh- the likelihood of an rh- woman and an rh+ man with an rh+ baby would be much, much lower). Rh- people continue to reproduce with out problems, passing rh- traits in hetero and **** forms onto their children and their children and so forth. My grandfather is rh-, his wife + and they had 2 rh- chilren. Their rh- son's both had kids (4 total) and of those kids one (me) is rh-. Had I choosen as rh- mating partner, I would not have any issues, but I have a partner who is rh+, and a child now who is also rh+ (although he likely carries rh- as a recessive in the hetero form).

So, the shot is not necessary per se. The species (and even rh negativity) would survive without its. But, there is no arguing with the fact that many, many women, my great aunt included, had multiple miscarriages and stillbirths before the shot was available.


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## GinaRae (Mar 27, 2007)




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## mamamoo (Apr 29, 2002)

Bump
Great info here, though I am still reeling from it all.


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## phathui5 (Jan 8, 2002)

I'm glad this was in the Birth forum, as I don't go over to Vax that often anymore (now that we've quit). I've been going back and forth on prenatal Rhogam and have now decided to wait and only get it if this baby is + after birth.


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## chanderann (May 18, 2007)

I became sensitized just 11 weeks into my first pregnancy after being involved in a roll-over accident. They had preformed an ultrasound at the hospital but they hadn't noticed any bleeding so I was let go. Then I notified my doctor and he said since the hospital had discharged me, that I was fine. I didn't know anything about rhogam at that point, so I didn't know to ask for it. At 28 weeks they discovered their error. I was sent to a high risk doctor and monitored very closely. However at 38 weeks my daughter was born severely anemic. After a few weeks in the NICU she was finally sent home. My second daughter was also affected but by only one of my anti-bodies so she only stayed 3 weeks in the NICU. Then I became pregnant again. At 18 weeks my son was allready severely anemic and had to have a PUBS/transfusion. Then another a week later, followed by two more 2 weeks apart. On the last transfusion, something went wrong and my son was born at 28 weeks. Now he is 34 weeks and he is still having transfusions and of course still in the NICU.

So the moral behind this story...get the shot! I wish that I had been able to get it.


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## mamamoo (Apr 29, 2002)

Quote:


Originally Posted by *chanderann* 
I became sensitized just 11 weeks into my first pregnancy after being involved in a roll-over accident. They had preformed an ultrasound at the hospital but they hadn't noticed any bleeding so I was let go. Then I notified my doctor and he said since the hospital had discharged me, that I was fine. I didn't know anything about rhogam at that point, so I didn't know to ask for it. At 28 weeks they discovered their error. I was sent to a high risk doctor and monitored very closely. However at 38 weeks my daughter was born severely anemic. After a few weeks in the NICU she was finally sent home. My second daughter was also affected but by only one of my anti-bodies so she only stayed 3 weeks in the NICU. Then I became pregnant again. At 18 weeks my son was allready severely anemic and had to have a PUBS/transfusion. Then another a week later, followed by two more 2 weeks apart. On the last transfusion, something went wrong and my son was born at 28 weeks. Now he is 34 weeks and he is still having transfusions and of course still in the NICU.

So the moral behind this story...get the shot! I wish that I had been able to get it.


I am so sorry this happened to you mama. Really!! The moral of that story though is educate yourself so you can get the shot it needed. You needed the shot at 11 weeks, and would have been affected by the 28 week one already anyway. It wouldn't have helped. I am so sorry mama. They should have done it.


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## applejuice (Oct 8, 2002)

http://www.informaworld.com/smpp/con...b=all~order=pa


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## Yulia_R (Jan 7, 2006)

Sorry, the post has been deleted to maintain some privacy.


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## Peppermint (Feb 12, 2003)

Will this be her first pregnancy? If so, it's not an issue..

Even if she has already had a positive baby, with today's technology and monitoring, she and babe would be fine. I have 2 neg and 2 pos children and no sensitization.


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## Yulia_R (Jan 7, 2006)

Sorry, the post has been deleted to maintain some privacy.


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## SaraFR (Dec 8, 2005)

Quote:


Originally Posted by *Peppermint* 
Will this be her first pregnancy? If so, it's not an issue..

Even if she has already had a positive baby, with today's technology and monitoring, she and babe would be fine. I have 2 neg and 2 pos children and no sensitization.

What technology is available for those who become sensitized? Are there still concerns for the safety of future pregnancies?


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## greenthumb3 (Mar 12, 2007)

Quote:


Originally Posted by *rozzie'sma* 
I would suggest reading Anti-D in Midwifery panacea or Paradox by Sara Wickham.









:


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## BrooklynDoula (Oct 23, 2002)

:d


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## Yulia_R (Jan 7, 2006)

Sorry, the post has been deleted to maintain some privacy.


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## colobus237 (Feb 2, 2004)

She could have a test (indirect Coombs) to see if she has Rh antibodies. If not, there will be no issues with Rh during this pregnancy.


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## BrooklynDoula (Oct 23, 2002)

Quote:


Originally Posted by *Yulia_R* 
I'm totally confused now







: . This whole thread is basically 'screaming' that Rhogam during pregnancy is BAD...
or isn't it?...

Some people argue that but ou will find A LOT of moms who have taken Rhogam here, myself included, who feel they made the best choice for themselves and their family and have no regrets about it. The studies sited are often from older versions of the drug, pre-2001 usually, and both my kids were born since then with mercury free versions of Rhogam.


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## SaraFR (Dec 8, 2005)

I was told by my doctor that the Rhogam is no longer from pooled blood and is now synthetically produced (ie not a blood product). Is this true?


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## wannabe (Jul 4, 2005)

If her previous miscarriages were in the first world with medical care, she'll have had rhogam and be fine. It'll be just the same as if the embryos were hers and an Rh + man's.


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## Peppermint (Feb 12, 2003)

Quote:


Originally Posted by *ccohenou* 
She could have a test (indirect Coombs) to see if she has Rh antibodies. If not, there will be no issues with Rh during this pregnancy.









: I did use RhoGam with each of my pregnancies, I can't say that I am 100% comfortable with that choice, but- it's what I chose. Did the mom in question have RhoGam after her miscarriages? I would *assume* she did if she hasn't read anything about it or questioned it. Most people don't argue against using it after birth or miscarriage, the main arguements are against using it while pregnant...


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## Yulia_R (Jan 7, 2006)

Sorry, the post has been deleted to maintain some privacy.


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## mamamoo (Apr 29, 2002)

Quote:


Originally Posted by *Peppermint* 







: I did use RhoGam with each of my pregnancies, I can't say that I am 100% comfortable with that choice, but- it's what I chose. Did the mom in question have RhoGam after her miscarriages? I would *assume* she did if she hasn't read anything about it or questioned it. Most people don't argue against using it after birth or miscarriage, the main arguements are against using it while pregnant...

I had a miscarriage and even asked about RhoGham, never got the shot.
That was before I read more about it, so glad it turned out that way, but just wanted to say they don't always give it routinely for m/c.

I think it would be very simple to have the antibodies test done, and it would tell you one way or the other.


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## WuWei (Oct 16, 2005)

Bumping, since this still comes up often.

Pat


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