Can someone explain the Rhogam stuff to me

mrsjengle · February 2012

I understand the basics about the blood, but I swear last time I was pregnant they went about things differently. I had a different doc in a different state, so either I'm misremembering or they do it differently at different practices.

This time I have to have labs drawn and the very next day I have to have the shot. Why is it the next day? Why do I have to have labs drawn if I get the shot no matter what? And, my doc said something about possibily getting another shot once the baby was born.

Help a girl out.

Daniellemf1228 · February 2012

I dont understand why you would need to get the shot the very next day. The lab is for an antibody screen I believe. As for the shot after the baby is born. My doctor told me I get a shot now (which I did yesterday) and after birth they will check the babies blood type. If the baby is indeed positive I will get another shot to reinforce the rhogam for future pregnancies. If it is a negative blood type I wont need a second shot.

kschriner2 · February 2012

I had to have the same thing. The bloodwork is done to type your blood, to verify that you have a negative blood type. This is probably at least the second time they've done that so it does seem repetitive, but it is also done to make sure your body hasn't already produced antibodies against your baby, which most of the time it hasn't unless you've had a placental tear or other bleeding that went unnoticed. The reason you have to wait till the next day is because they have to process the blood work, I had to go and have the blood work and then come back 3 hrs later, or worse yet, they said i could wait there in the hospital for the 3 hours, so its kind of nice they let you go home and come back the next day. As for the shot when your baby is born, they will only do that if your baby has a positive blood type and its just to protect you and your baby from any blood that may have mixed during delivery. Also it helps protect any future babies you may be having! The whole process is annoying but its a good thing to do and once its over, its over! Goodluck!

LilyPotter218 · February 2012

Have you had one already? If you have, your blood draw will show you are RH+. Rhogam lasts in your system for 10 weeks. They may want to check to see if you actually needed another one?

I have had 2 already. First tri was b/c I am O- and was bleeding. Second was at 28 weeks to get me to the end, and if depending on her blood type, I will get another one after she is born. If baby is + and you do NOT get the shot after delivery, your body may attack future pregnancies as a "foreign invader".

tiannalee · February 2012

Daniellemf1228:
I dont understand why you would need to get the shot the very next day. The lab is for an antibody screen I believe. As for the shot after the baby is born. My doctor told me I get a shot now (which I did yesterday) and after birth they will check the babies blood type. If the baby is indeed positive I will get another shot to reinforce the rhogam for future pregnancies. If it is a negative blood type I wont need a second shot.

Just to add a little: after baby is born, they will test your blood to see if you have developed any antibodies to the Rh+ antigen and if so, they use an equation based on the number of antibodies per titer to figure out how many vials of anti anti-D to give you. This will neutralize any possible antibodies you may have made.

Someone asked about this on the April board so here is a cut and paste of my response:

Being Rh- means you lack all (or most) parts of the D antigen on your red blood cells. If your hubby/significant other is positive, your baby can be positive. Your blood and baby's blood mix and you will develop antibodies to the baby's blood. Luckily enough, if you receive the shot in your 1st pregnancy, it is unlikely that you will make any antibodies. However, if you do, this usually does not affect the 1st pregnancy since it is the 1st time being exposed to it, however, any subsequent positive children will cause an all out immune response against the baby's red blood cells = bad news bears.

The shot is made up of antibodies to antibodies to the D antigen = anti anti-D and in effect, neutralizes any antibody you may have already made to prevent it from going near the baby. In very rare instances, this is not effective and hemolysis (or breakdown) of the baby's red blood cells occurs as your antibodies attack. There are different treatments if such a thing did happen and baby is usually born very early.

Unknown · February 2012

This content has been removed.

mrsjengle · February 2012

tiannalee:

Daniellemf1228:
I dont understand why you would need to get the shot the very next day. The lab is for an antibody screen I believe. As for the shot after the baby is born. My doctor told me I get a shot now (which I did yesterday) and after birth they will check the babies blood type. If the baby is indeed positive I will get another shot to reinforce the rhogam for future pregnancies. If it is a negative blood type I wont need a second shot.

Just to add a little: after baby is born, they will test your blood to see if you have developed any antibodies to the Rh+ antigen and if so, they use an equation based on the number of antibodies per titer to figure out how many vials of anti anti-D to give you. This will neutralize any possible antibodies you may have made.

Someone asked about this on the April board so here is a cut and paste of my response:

Being Rh- means you lack all (or most) parts of the D antigen on your red blood cells. If your hubby/significant other is positive, your baby can be positive. Your blood and baby's blood mix and you will develop antibodies to the baby's blood. Luckily enough, if you receive the shot in your 1st pregnancy, it is unlikely that you will make any antibodies. However, if you do, this usually does not affect the 1st pregnancy since it is the 1st time being exposed to it, however, any subsequent positive children will cause an all out immune response against the baby's red blood cells = bad news bears.

The shot is made up of antibodies to antibodies to the D antigen = anti anti-D and in effect, neutralizes any antibody you may have already made to prevent it from going near the baby. In very rare instances, this is not effective and hemolysis (or breakdown) of the baby's red blood cells occurs as your antibodies attack. There are different treatments if such a thing did happen and baby is usually born very early.

This helps. I'm starting to remember my old ob saying that it was more to protect my second/subsequent pregnancies than the current one. As far as having to have the shot the day after the bloodwork, that's apparently just their policy. They just made such a big deal out of it like the shot wouldn't work if I didn't have it the very next day.

cjevar · February 2012

Mine did the same blood drawn, had to have the shot by a certain date (not necessarily the next day) and then wait and see if this LO is positive like her sister then I will have to get another.

ShelbyBray · February 2012

Im in the same boat (o-) and unfortunately don't have a lot of experience or help to offer. But I know for me I've had more rhogam shots than normal because I've had issues with placenta previa and bleeding and the labs after the shot ensure that the rhogam is active in your system.

I've also heard that for your second pregnancy the rh factor can be more critical than the first. (Higher chance that the baby will have a different blood type than you.)

Lesleyjking · February 2012

I had to have mine at 28 wks (though given at 27 due to bleeding), I get another after delivery.

Mrs.Wifey318 · February 2012

you have to have it about 26 or 27 weeks and then again after delivery because the shot only lasts about 13 weeks. It may have been that you had your labs drawn close to the 26-27 week timeframe. HTH

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