Dear Rhesus negative woman married to a Rhesus positive man…

I guess you have heard about the anti-D immunoglobulin (Rhogam ®) injection which should be taken in order to prevent you from producing antibodies against your unborn baby. Please note that the injection taken in one pregnancy is intended to protect your baby in the next pregnancy. Failure to take this injection may lead to hemolytic disease of the newborn or a stillbirth.

Also, note that there are guidelines on when to take the injection and what dose to be taken…

*Normal pregnancy at 28 to 32 weeks, after “antibody testing”. Ideally, two doses should be taken at 6 weeks’ interval.

*Within 72 hours of a normal delivery of a Rhesus positive baby. The earlier the better, but it can still be taken up to 10 days post delivery.

*Any significant bleeding during pregnancy, starting from 12 weeks. Dose is calculated according to the degree of “fetal to maternal” blood loss.

*Miscarriage from 12 weeks of pregnancy

*After surgical evacuation following such miscarriage

*In case of ectopic pregnancy

*In case of molar pregnancy

*Invasive procedures during pregnancy which potentially result in “feto-maternal” bleeding (eg. Amniocentesis)

======================

Who does NOT need Rhogam?

*Pregnant woman who has already been “sensitized”. This is confirmed by an antibody test done around 28weeks. This means that she already has antibodies against her baby. In this case, it is very likely that the baby has been affected and close monitoring is all that can be done. The fetus may be transfused in advanced centres or delivered early and managed in a neonatal ICU.

*Rhesus negative mother whose baby is also Rhesus negative.

*Rhesus negative mother whose husband is also Rhesus negative. (Provided that the paternity is not debatable)

Feel free to ask questions if you’re in doubt!

©KT
19-04-2020

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