1st Trimester

Rhogam shot....Confused?!?!?!?!

Hey everyone, i have a question for everyone out there, im asking for my friend..she cant seem to get any answers so im  wondering if anyone has been through this. She is currently 9 weeks pregnant. about 6-7 weeks in she was having some spotting, nothing crazy..i told her i thought it was normal but she should call her dr. to get some peace of mind. then last monday she started getting a different kind of discharge, it was pink/brown (no cramping). She called her Dr. and the nurse there told her it was normal and since she had her 8 week apt. in 2 days to talk to the dr then about any other concerns. Well her apt came and during her internal exam the dr sound some blood...then they also noticed that her blood type was A-, so she had the RH factor (why it took them this long to realize that is beyond me, as soon as she complained of spotting they should have looked at her chart and saw that) So since there was concern they told her to come back later that say for an internal u/s and get blood work and the rhogam shot (because her body was attacking the baby as if it were an infection). The u/s showed that the baby looked more like 6 weeks instead of 8, and the heart rate was low at 108 when it should be closer to 170s (she is a smoker). Her blood results came back and her hormone levels were 1500, low for 8 weeks. While at the hospital she started to bleed, not a ton but there was definately blood. They sent her home and told her to come back for more blood tests for the next few days and another u/s in a week. They did not tell her that she was miscarrying, but they said it was a possibility that she started to miscarry on the monday before...they would just have to wait and see. She cant seem to get any answers on what the odds are that the baby will survive. Can the baby bounce back even though it seems her body as already started to attack the fetus and who knows for how long??? if given the shot in time could it save the baby? Its been 5 days since her first blood work and she has had some bleeding everyday since, not a huge amount, and cramping here and there. 
Any info we have found says that they give the rhogam shot after a miscarriage, but they arent saying that she is actually having a miscarriage. Would it take this long to miscarry?
All she can find out is that its just a waiting game? its her first pregnance and Its a rough time for her right now and some answers/input would be great! thanks!

Re: Rhogam shot....Confused?!?!?!?!

  • They give the Rhogam shot if she was bleeding. If she starts to miscarry and her blood mixes with the baby's blood, if the baby's blood was positive, that would be bad.

    Usually bloodwork is done at the 8 wk appointment, so yes, that's normal that they determined she was Rh- at that point.

    The shot will not save the baby, the shot protects the mother.

    There is no way to tell if she's still miscarrying or if she hasn't even started except by ultrasound or until she passes tissue and clots.

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                                        Tessa: 10/28/10                    Nora 8/30/12                            Reid 8/6/14
  • thanks for your reply! she got blood work done at 6 weeks, thats why i thought they would have noticed, esp. when she started to complain of spotting. Anyway, guess it is just a waiting game..and hope for the best.
  • image dmc413:
    thanks for your reply! she got blood work done at 6 weeks, thats why i thought they would have noticed, esp. when she started to complain of spotting. Anyway, guess it is just a waiting game..and hope for the best.

    Typically, it goes in the chart, but the shot isn't actually given until 28 weeks or so unless she is bleeding. It was probably just an oversight but the shot just protects her if her baby's blood and hers mixes during a m/c.

    image
                                        Tessa: 10/28/10                    Nora 8/30/12                            Reid 8/6/14
  • If this is her 1st pregnancy she would not have the antibodies to "attack" the fetus. If you are RH- and baby is RH+ and the blood mixes, that is when your body produces the antibodies. Just because you are RH- does not automatically mean you can't have a RH+ baby.
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  • yeah she had some spotting and colored discharge so i dont know if the blood could have mixed then or if there was already a problem with the fetus and she was going to miscarry...Her Dr. doesnt seem to give her much info. Shes gotten more answers on the internet, but its all so up in the air right now they may not want to really say much, idk.

    But i just got an update from her, her hormone level went up alittle, i guess not as much as they would like so they canceled her blood work she was suposed to get today and told her to just come in wednesday for an ultrasound to see if there is still a heart beat. Not really sounding to good but she hasnt bleed to much she hasnt passed any tissue so i guess you never know..

  • Very well said, in cases where there is no bleeding, rogham is given later in pregnancy I believe...in addition to the above, it's not considered a m/c until there is no HB or no baby. In order to tell if it's a viable preg they'll correlate ult findings with HCG levels.
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  • Sounds like they are following closely, she'll know soon! Keep us updated, best wishes to all!
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