Rh issues

[WuWei]

I'm looking for info about the Rh issues and thimerosol and alternatives for a friend who'd rather not do the injection.

Didn't find any links in the Resources here or Homebirth or in Vaccination.

Thanks,

Pat

[JessicaS]

There are thimerosol free alternatives

WinRho SDF, is manufactured by Canjene Corporation of Winnipeg, Canada, and distributed by NABI (1-800-458-4244, option #2). A package insert in PDF format and other product information can be accessed by you and your doctor at the NABI website,

Here is a discussion including a section regarding Rhogam at Midwifery Today.

http://www.midwiferytoday.com/enews/enews0235.asp

[stik]

According to the manufacturer's website, Rhogam is also now thimerosol-free.

Your friend should also make sure she knows her partner's blood type - if both partners are Rh- there is no possibility of Rh disease and no need for treatment.

[Paigekitten]

I am O negative, my DH is o positive, both our daughters were negative. With my second I didn't want to get the shot so we did blood draws during the last couple months of the pregnancy to detect if my body was making the antibodies and then didn't need the shot after the birth since she was O negative. My midwife didn't get why a bunch of blood draws was better then one shot just in case, but I didn't want to take chances, and I didn't want a vaccine I didn't need.

[MsBlack]

Not that I am a fan of prenatal Rhogam (except when there is a sign of possible mother-baby blood mixing/placental disruption), but once you have antibodies, it's too late for Rhogam. Rhogam *prevents* creation of antibodies if there is a placental disruption and blood mixing during pregnancy (or birth). A couple months back there was a lengthy discussion on this forum about Rh- and when Rhogam is useful, benefits or not or prenatal shot--lots of info and clarification there.

But we didn't cover Rhogam's constituents at all--and to my knowledge, thimerisol has been removed from all (most?) shots/vaxes, including Rhogam, a couple years back.

[Defenestrator]

One thing I offer to do for my clients who want to refuse rhogam is to do a Kleihauer-Betke or Fetal Hemoglobin test (same test, different name) after the birth. The biggest impact of rhogam is when it is administered after the birth -- it takes the sensitization rate from about 10-15% to about 1%. Adding the prenatal rhogam cuts it further, I think to about .5% (but don't quote me on that).

So in my practice, if a mom wants to refuse prenatal rhogam, fine. Then I usually advise the postnatal rhogam but if she feels really strongly about that, I offer the Kleihauer-Betke test. That test stains the fetal blood cells in the mom's blood a different color and counts them. If there are any detectable cells then I make a much stronger case for the rhogam. If not, then I usually counsel them that the test can't detect very small amounts and there are no guarantees, but at least we believe that there hasn't been noticeable blood mixing.

[WuWei]

Thank you very much for the info!

Pat

[terra-pip]

Originally Posted by WuWei

Thank you very much for the info!

Pat

hi Pat..bekah from alwaysunschooled. I still have an email folder full of your yahoo group posts!

[MsBlack]

Originally Posted by Defenestrator

One thing I offer to do for my clients who want to refuse rhogam is to do a Kleihauer-Betke or Fetal Hemoglobin test (same test, different name) after the birth. The biggest impact of rhogam is when it is administered after the birth -- it takes the sensitization rate from about 10-15% to about 1%. Adding the prenatal rhogam cuts it further, I think to about .5% (but don't quote me on that).

So in my practice, if a mom wants to refuse prenatal rhogam, fine. Then I usually advise the postnatal rhogam but if she feels really strongly about that, I offer the Kleihauer-Betke test. That test stains the fetal blood cells in the mom's blood a different color and counts them. If there aren't any detectable cells then I make a much stronger case for the rhogam. If not, then I usually counsel them that the test can't detect very small amounts and there are no guarantees, but at least we believe that there hasn't been noticeable blood mixing.

The bolded part has me confused about what you mean--can you say that again a different way maybe? thanks--

[Defenestrator]

No wonder why you're confused. I think I had edited to change my word order and then ended up saying the opposite of what I meant. Sorry! I edited the original post.

[MsBlack]

Ok then, now having reread your edited post, I can safely say-- THAT I do understand! And agree with.

[AlexisT]

Originally Posted by Paigekitten

My midwife didn't get why a bunch of blood draws was better then one shot just in case, but I didn't want to take chances, and I didn't want a vaccine I didn't need.

Rhogam is not a vaccine.

[honeybee]

Someone in another board posted this link about a blood test finding out the rh factor of your baby while you're still pregnant, to help in the decision making. I'm considering it.... except I don't know if I want to know baby's gender.

http://www.naturalbirthandbabycare.c...enotyping.html

[WuWei]

I'm so delighted to be able to come here and receive informed resoruces and discussion about these challenging issues!


Thank you all!


Pat

[Paigekitten]

Originally Posted by MsBlack

but once you have antibodies, it's too late for Rhogam. Rhogam *prevents* creation of antibodies if there is a placental disruption and blood mixing during pregnancy (or birth).

Right, the monitoring I chose to do was for the creation and possible increase of antibodies as a way of determining fetal Rh distress, NOT to decide whether or not use Rhogam. Sorry that wasn't clear in my post.

[Paigekitten]

Originally Posted by AlexisT

Rhogam is not a vaccine.

Once again, sorry about that. Rhogam is a medicine, and I meant to say injection in my post, it was late and I had two little ones climbing all over me and apparently I was typing faster then I could think.