# Rhogam after miscarriage



## inconditus (Oct 1, 2012)

I'm still reeling from my first pregnancy and miscarriage and the topic of being RH negative comes up with my doctor. I'm on the website for rhogam right now but of course there is no real information on it. Google searching isn't getting me anywhere (albiet I'm not trying too hard) in finding out whether or not the shot is needed. I'm usually pretty weary of shots but if by chance it's a legit concern that I wouldn't be able to carry to term without it then I'd get it... but if it's like the flu shot I dont care.

Any information or help would be appreciated. Thank you <3


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## baileyb (Dec 22, 2010)

It depends on your situation. If you are Rh - and the father of the baby is Rh + then I would recommend getting it. If you happen to carry a Rh + baby and your blood somehow mixes, as in some sort of trauma like a car accident or whatever, then it can effect your future pregnancies. If your blood mixes with Rh+ baby's blood your body will build up antigens against + blood and any future babies you carry that have + blood, your body will attack it like it is a foreign object. This causes the baby to be anemic and can call for a whole host of not so good things like intrauterine blood transfusions, preterm labor, and I have seen one statistic that there is an 80% survival rate of babies with this sort of complication.

Sorry to be a downer. I didn't know any of this until a few weeks ago when my prenatal blood work showed I had antigens in my blood. For me it turned out to be just left over Rhogam shot from a m/c I had in May and not anything to worry about.


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## inconditus (Oct 1, 2012)

Thanks for the response. It seems it's not needed until my next pregnancy and not this one. I was mistaken.

Hm. I suppose from here I should just make a note that next time the husband goes to the dr. to have him get some blood taken to see if he's RH + or -.


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## IdentityCrisisMama (May 12, 2003)

Quote:


> Originally Posted by *inconditus*
> 
> Thanks for the response. It seems it's not needed until my next pregnancy and not this one. I was mistaken.


Really? How far along were you?


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## MeepyCat (Oct 11, 2006)

Inconditus, Rh sensitization issues would potentially affect your next pregnancy, but to avoid the potential for developing a sensitization, you should get the Rhogam shot as soon as possible. The Rhogam shot works by preventing antibodies from developing when the exposure to the Rh factor first occurs. Once the antibodies have developed, Rhogam won't make any difference.

If the miscarried baby was Rh+, and if there was any blood mixing during the miscarriage, you would potentially begin your next pregnancy sensitized to Rh factors, which could have serious consequences for that pregnancy.

Rh factor incompatibility can cause hemolytic disease of the newborn, which killed thousands of babies every year before Rhogam was developed. It's now possible to treat Rh factor sensitization in utero, but it's a very intensive treatment, with far greater risks then Rhogam.

I'm Rh-, with one Rh- and one Rh+ kid. Unfortunately, the Rh+ kid is also the one where I experienced a ton of bleeding during pregnancy. She would probably not be here without Rhogam. This is not like a flu shot, where it's not all that effective, and the consequences of the flu aren't that bad for most people anyway. Rhogam is very safe, and very effective, and solves a problem that caused unspeakable grief for many families. As you can see, I'm strongly in favor.

If you can drag your DH for a blood test in the next few days, check if he's Rh-. Otherwise, I would get the shot.


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## womenswisdom (Jan 5, 2008)

Quote:


> Originally Posted by *Inconditus*
> 
> Thanks for the response. It seems it's not needed until my next pregnancy and not this one. I was mistaken


No, this is not correct! The Rhogam is given in order to _prevent_ problems in your next pregnancy that can be caused if you've been sensitized by this pregnancy. That is why the shot is needed now - in order to prevent your body from making antibodies that will affect your next pregnancy. Repeat - this is NOT something you wait until next pregnancy to do. It must be done THIS time in order to prevent problems with your next pregnancy.


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## dayiscoming2006 (Jun 12, 2007)

When is it a problem? I had an early miscarriage last month. I figure I'm fine since it was really early - 4th week and I didn't know about potentially needing rhogam until it would have been useless anyway. - I know you need to get it within 72 hours of potential blood mixing, sooner the better. But, if I miscarry again and I'm further along. Anyone know?

I had a sensitization test done the first day of my miscarriage to make sure that didn't cause the miscarriage and it came back fine.


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## jodieanneanton (Apr 8, 2010)

dayiscoming2006- If the miscarriage is very early, 4-5 wks pregnant, then you would not need the rhogam. Any farther along than that, it would be strongly advised.


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## japonica (May 26, 2005)

The usual protocol is rhogam within 72 hours, depending on how far along the pregnancy is. As far as I know, m/cs in the 4-5w range would not require it.

It also has a failure rate of about 1%. I'm one of those "surprise!" cases of rhogam failure even though it was correctly administered and I was still negative for anti-D at the time of my last prenatal shot. I also lost my daughter for unknown reasons after that point, but the pathology pointed to some kind of systemic immune reaction that began at the time of the last shot. Just one of those coincidences, I suppose.

I had two sensitized pregnancies after that and required monitoring by the peris but no IUTs nor any intensive treatment whatsoever. After a week under bilis, both kids were fine and required no further treatment. They each made it to 37w before induction.

Yes, HDN and sensitization can be serious but it can also be unproblematic. Everyone's circumstances and experiences are different. I know my peris were pleasantly surprised when I made it through my second iso pg, with titers of 1:64, and didn't require a single IUT. And DS was B+ as well.

Quote:


> Hm. I suppose from here I should just make a note that next time the husband goes to the dr. to have him get some blood taken to see if he's RH + or -.


It might be different in the States and with different HCPs, but back in Canada they usually recommend all Rh neg women get rhogam and they don't bother to test the father-to-be unless 1) the mother has a strong suspicion he is Rh neg and argues for testing to avoid the shot or 2) the mother is already sensitized and they are testing the father to find out if he is hetero or homozygous for that particular antigen (in this case D). My DH was not tested until it was confirmed that I was indeed sensitized with a titer of 1:2.


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