Re: [ozmidwifery] RH -

Mon, 25 Jul 2005 06:39:33 -0700

Hi Jo,
Directed at your Mothers enquiry:
 
There really isn't another 'point of view', just the facts.
 
The management of Rh Neg women during pregnancy has altered in the past 1-2-years. Possibly this has caused confusion because your Dr is suggesting a new strategy which he hasn't fully explained. Also we accustomed to antibodies being a good & positive thing, in discussing the RH factor it's messy because they are an undesirable thing. Hard to get the head around! The following is routine management.
 
I wonder if it's clearly understood that the idea of Anti-D or Rhogam is to prevent the formation of antibodies. In this regard you have done all the right things as you have no antibodies present in your blood. If you have antibodies to the rhesus factor in your blood you have become
"iso-immunised" (i.e. immunised against the RH factor). By giving women who are RH Neg Anti-D or Rhogam during their pregnancy (at 28 & 34 weeks) any undetected small bleed that may have occurred unbeknownst to the mother will not affect her antibody status.
It is designed to prevent her body forming antibodies to the unborn baby's blood (as s/he has an unknown status, i.e. we are unable to determine whether the baby has or doesn't have the RH factor until s/he is born & we test the cord blood).
 
The big picture is to wipe-out iso-immunisation from the population & the most common time for it to occur is with pregnancy ( it can occur at other times as well i.e. an incorrect blood transfusion). So eventually no women in Aust will be iso-immunised.
 
Of course you would never put you baby at risk, that's why you are checking you are doing the appropriate thing. You are being a responsible mother, checking things out before going ahead because someone said "because that is just what's done". Good on you !
You are in the perfect position to have Anti-D/Rhogam as you are NOT iso-immunised, so long as you have no objections to receiving a blood product, you are following the presently recommended protocol.
 
Tech Info at:
 
Hope this helps.
Brenda M
 
----- Original Message -----
From: jo
Sent: Monday, July 25, 2005 10:49 PM
Subject: [ozmidwifery] RH -

Hi wise midwives,

Below is a question received through the HAS website. Could anyone please help with an answer.

Cheers

Jo hunter

 

Hi

Hope you could help with another point of view please.

I am 28 weeks pregnant I have a 5 year old & 2 year old and had a missed miscarriage on the 9th November last year, after each child I have had the RhoGAM injection including with the miscarriage before I had a D & C (11week 5 days) although baby had stopped growing at 8 1/2 weeks.

I am having a home birth with a reg midwife and went to the doctor to ask for blood form to have the babies cord blood tested at birth to see if I need the RH injection.

I am now being told that I have to have the injection again now at 28weeks and 34 weeks regardless !

This did not happen with my 2nd child and there are no antibodies showing at any blood test .

Why ? all the doctor will tell me is because that is what is done.

I would never put the baby at risk and would like another opinion.

Many thanks

 

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