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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2 thoughts on “Dear Rhesus negative woman married to a Rhesus positive man…

  1. Tadese Adekunle 18/08/2022 / 11:55 am

    Thank you so much for this priceless piece of professional advice and enlightment.

    But I have a very serious question about a serious case. My wife is a Rhesus negative but due to lack of medical knowledge about this status, I didn’t know when to take the anti D injection, but my wife got pregnant and she had a miscarriage at about few days to 8 week, I thought it’s only during or after child birth that she will be taking the injection, meanwhile, the doctor taking care of my wife I don’t know maybe he forget or he didn’t know her blood group, but he didn’t tell us anything about it that the injection should be taken within 72hours but after about 7th week of the evacuation a friend told me that we ought to have taken that Rhogam injection, I told him , I thought it’s only when a woman deliver but he said even after miscarriage it should be taken, then I went back to the doctor and he said yes even as it was about 2months after the evacuation we still took the injection. That’s about the past 4 months or thereabouts but my wife has not have any other pregnant after then until this month when she was supposed to see her period between 11,12 and 13 but she didn’t see it until this morning 18 when she saw a blood stain when she was urinating, at first, I thought God had answered our prayers, when we saw that we rushed to the same doctor,he tested and said it was to early for the scan to see, he gave her injection and some drugs and ask her to go home and be resting but my surprise the blood is still coming. Please I need your professional advice.

    Thank you so much in anticipation

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    • Doctor KT 18/08/2022 / 12:24 pm

      1. Sorry to hear about the miscarriage.
      2. The blood coming now might be her menses resuming.
      3. Your wife will be fine. Too much anxiety might delay her from getting pregnant. Let her rest and she will get pregnant when her body is ready for it.

      All the best!

      Like

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