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Rh- Question.../Rhogam Indication Question

post #1 of 10
Thread Starter 

Anyone have any experience with getting a shot BEFORE the 28 weeks for a possible accident?

 

DS (about 100 pounds) was messing around kind of stumbled and landed hard on the upper right portion of my belly with his hands extended.  I was lying down on my left side on the couch and he kind of landed on the upper right part of my belly.  I let out quite a yelp and obviously was pretty upset (cried afterwards actually I was kind of freaked out about it).  It's already been a stressful week and can't believe that this crud happens on top of everything else.  

 

I'm just under 27 weeks now, I am sort of wondering if it's something that I should consider getting the rhogam shot early for.  My three year old has bumped me plenty of times, but this was nothing like this.  I don't know where my placenta is, etc. so I don't know if that would be a factor to consider or what.  Baby is fine as far as I know, plenty of movement!

 

I'm just wondering if this was 'violent' enough to actually do any potential blood mixing?

post #2 of 10
I don't know whether this could cause bleeding, but you could call your doctor or midwife and ask. That's what i'd do.
post #3 of 10

I would ask your doctor.  The 28 week date isn't hard and fast.  In fact, there isn't a lot of evidence supporting it according to my doctor; it's just a kind of arbitrary point they choose that seems to come close to maximizing protection.  So you could easily get the shot at 27 weeks and not have to worry either way.  If I were you I would probably do it for piece of mind, especially because you're so close to 28 weeks anyway.

post #4 of 10
Ask your OB or midwife to test you for antibodies.
I think it's a fairly simple test. I had it done after both of my births so I could decide about taking rhogam during pregnancy again. Results were back by the next day I believe.
post #5 of 10

Yes-if you are getting the shot at 28 weeks and had trauma, I would get it early.  You need to get it within 72 hrs of the incident, *if* it caused blood mixing, in order to prevent sensitization.
 

post #6 of 10

Just for everyone's knowledge. Rhogam doesn't actually provide any help prenatally. It might decrease your chance of sensitization by 1% and has it's risks since it is a blood product and does contain less than ideal preservatives, etc. It is good for if there is a bad trauma, car crash, etc. And, it is good to get Rhogam within 72 hours of delivering your baby if they are rH+. If your DH/DP is rH-, then you do not need rhogam. 

post #7 of 10
Quote:
Originally Posted by dayiscoming2006 View Post

Just for everyone's knowledge. Rhogam doesn't actually provide any help prenatally. It might decrease your chance of sensitization by 1% and has it's risks since it is a blood product and does contain less than ideal preservatives, etc. It is good for if there is a bad trauma, car crash, etc. And, it is good to get Rhogam within 72 hours of delivering your baby if they are rH+. If your DH/DP is rH-, then you do not need rhogam. 


Well, it does provide protection prenatally in case of an accident, which is what the OP was asking about. 

post #8 of 10

Prenatal rhogam is tons of help prenatally - if there's trauma or other reason to suspect blood mixing, you should get it!

post #9 of 10
Quote:
Originally Posted by MeepyCat View Post

Prenatal rhogam is tons of help prenatally - if there's trauma or other reason to suspect blood mixing, you should get it!

Key thing: if there is major trauma of some sort to suspect the blood is mixing, it makes sense prenatally. But, just at random at 28 weeks, it makes no sense because it only has an effect if the blood mixes within 72 hours. Hope that clarifies what I was saying.

 

And yes, I agree that is what the OP was talking about, but hoping to be helpful in letting OP know that at 28 weeks, unless she has another trauma of some sort, she wouldn't need any rhogam. HTH 

 

I don't know that what happened to OP would be enough to cause real harm, it depends what kind of pain she experienced after, but if she really suspected blood mixing, she should go with her gut.

post #10 of 10

Rhogam stays active in your system for up to 12 weeks.  So it can usefully be given prophylactically, as well as within 72 hours of a known exposure.  I had placenta previa during my last pregnancy, and was exposed to my daughter's Rh factors despite experiencing neither bleeding nor pain.  Fortunately, we were able to test my immune titers, and administer Rhogam anyway (twice during the pregnancy, and once afterwards) to prevent sensitization.

 

The available evidence on prenatal Rhogam is that antenatal administration at 28 weeks reduces the rate of Rh sensitization - "Without antenatal anti-D prophylaxis, 1.6% to 1.9% of Rh-negative women at risk become sensitized. Routine antenatal prophylaxis reduces the rate of sensitization during pregnancy to 0.2%, as shown by at least 9 clinical studies of antenatal prophylaxis with anti-D immune globulin."  (http://www.sogc.org/guidelines/public/133e-cpg-september2003.pdf).  A reduction from 1.6% to .2% is an 87.5% reduction in the rate of prenatal sensitization - the change in absolute risk isn't that huge, but the change in relative risk is a very big deal.  (Also, keep in mind that the 1.6% to 1.9% risk of sensitization assumes that women at risk will receive Rhogam post-partum.)

 

Rhogam no longer contains thimerosal, and while it is a blood product, it has never been linked to the transmission of blood borne disease.

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