Rhogam - Page 3

[wasabi]

I think this was the link I was thinking of.

http://www.*********/a/rhogam.html

And this one:

http://www.gentlebirth.org/archives/...re.html#RhoGAM

[maxmama]

Originally Posted by wasabi

I honestly don't know what Kell is but I do know a lot about Rh sensitivity. I have no idea if Kell sensitization is harder or easier to achieve during a normal pregnancy than RH sensitization. As I mentioned previously it is thought that it would take multiple microbleed to achieve actual RH sensitization I have no idea if the same is true for Kell. However if you were positive at 28 weeks and we subsitute RhoGam for Kell then you would still have been sensitized because you don't get the shot until 28 weeks. As I believe a previous poster mentioned your case actually proves the problem with the idea of giving the shot at 28 weeks preventing prenatal sensitization because you would have been sensitized before your prophalactic shot. There is a 1.8% chance of prenatal RH sensitization and that includes all women even those who were involved in severe traumas that put them squarely at risk for a microbleed. Again I have no idea what the risk is for Kell relative to the risk for prenatal RH sensitization. If I assume that it is similar to the risk of RH sensitization then you have to weigh whether or not being in that tiny tiny group (well less than 1.8%) is worth it or not. In my case I judged it was not worth it. In your case you're saying it would have been worth it. Just as in all cases where something is extremely low risk it doesn't matter if that .05% is you and I get that. But I think it is important to present facts about the risk and let people make their own judgements. In the huge, vast marjority of cases women who go through a normal pg with no spotting or trauma are just as well served getting a postnatal shot if the baby is positive.

My point is that I disagree with a categorical argument against antenatal RhoGam. My "28 week" labs were actually probably 30 week labs, based on how my 36 weeker looked when born. The argument for using antenatal RhoGam at 28 weeks is that with most pregnancies, there isn't enough volume of fetal blood to sensitize if there is a silent (not necessarily micro) bleed until approximately 28 weeks. Obviously, YMMV.

[theretohere]

Someone mentioned a risk to + baby girls later- is there any information out there about this?

[SuperMoM2GTO]

I had the rhogam shot @ 28 weeks and* after birth... Is my son at risk now that I did??? I had NO idea rhogam was the blood of other people :yuck: Should I get tested for HIV?

[AmieV]

I would not worry about HIV from a rhogam shot. They screen blood products very carefully.

What you can worry about if you're looking for something...is the viruses we don't know about. there's no telling how many hepatitis viruses there truly are.

I hadn't read all the information here, but there were some stats in Ina May's book that convinced me the antenatal shot was worthwhile. My m/w uses Rophylac? or something that I always spell wrong that is cleaner as far as preservatives go. The effects of sensitization were just so devastating that the risk/benefit ratio for me personally worked its way out into me getting the shot. I didn't have MT's info though...but honestly I didn't read it more than once and I don't really understand it. and what's done is done so I'm just going to go to bed instead.

I've had 3 doses of rhogam...one after my m/c and one during both pg's. And it was all for naught...both my girls are RH negative and oh goody, get to research this issue when they get old enough to have babies!

the one bizarre thing is that my m/w offered it to me after knowing dd2 was negative. She said some people feel like you can still sensitize, especially the more pg's you have. This made absolutely no sense to me, and it was weird because she's anti all the other vaxes. I didn't question her a lot on it because this is my last baby anyway, and it was 2 days post partum so I wasn't up for discussing stuff like that.

I had no idea it was a blood product the first time I had it either. Nice "informed consent", huh?

[SaraFR]

I also never knew it was a blood product.

[japonica]

Yup, it is.

From http://www.rhogam.com/English/Profes...rofRhogam.aspx

RhoGAM® and MICRhoGAM® Ultra-Filtered are made from human plasma. Because these products are made from human blood, they may carry a risk of transmitting infectious agents, e.g., viruses, and theoretically the Creutzfeldt-Jakob disease (CJD) agent.

[SaraFR]

Originally Posted by japonica

Yup, it is.

From http://www.rhogam.com/English/Profes...rofRhogam.aspx

Not reassuring for those of us who have had it (twice) before knowing.

[maxmama]

Originally Posted by SaraFR

Not reassuring for those of us who have had it (twice) before knowing.

i've had ten doses plus been transfused twice, and I'm not worried.

[mamakay]

Originally Posted by maxmama

i've had ten doses plus been transfused twice, and I'm not worried.

Er, so have you ever read about the problem of adventitious agents in biologicals?

If so, what are your thoughts?

[Peppermint]

Originally Posted by iamleabee

The only antibody to cross the placenta is IgG. This is what the immune system eventually makes after an exposure to antigen, so that a second exposure has a rapid immunilogical response.
:
RhoGam is an IgM anti-D immunoglobulin that binds to the D antigen and eliminates it from the body, thus preventing the maternal immune system from seeing it and forming IgG antibodies against it. The difference is that IgM antibodies are too large to cross the placental barrier, and therefore cannot harm the fetus (they contain 5 subunits), whereas IgG antbodies are small and do cross the placenta and attack fetal RBCs.

:

I already quoted this and asked for some references for this, and perhaps I am being impatient, but I would really like to hear more on this assertion, from either side, preferrably both sides. Thanks!

[mamakay]

Originally Posted by Peppermint

I already quoted this and asked for some references for this, and perhaps I am being impatient, but I would really like to hear more on this assertion, from either side, preferrably both sides. Thanks!

I'm meaning this in a very unsnarky way...(seriously)...
But you can look the information up yourself at this point.

[Peppermint]

OK, here is what I find: (with a quick search)
http://www.madsci.org/posts/archives...8607.Me.r.html

http://www.path.sunysb.edu/coursemat...odlymphoid.htm

http://www.mfi.ku.dk/ppaulev/chapter32/kap32.htm

which all seem to agree with what I quoted, that the IgM *is* too big to cross the placenta. My issues are 2- I find MT to be very well-researched, and generally don't find her spouting things that aren't true, which leads me to the second part being, I don't know how to research this as well as I should, I suppose. All I can do is search google and see what comes up, I have found that I miss a lot when I try to look into things myself, and in the past others on this forum seem to be able to find the "other side" easier and help me see what I am missing.

I am simply a few weeks from having this injection again, and want to make the right choice. I am not having a "normal healthy pregnancy and intervention-free birth" so it really is more of an issue for me. One of the most convincing things I saw which made me re-think getting the shot, was the idea that it could hurt this baby, the one I am carrying *right now*, HE is my main concern, and I want to see him born healthy, and have a lot to consider with that.

This seems so different from all of the vaccines we discuss here, which, for me, have been easily proven not only harmful, but ineffective and unnecessary. I am feeling like this is not so cut and dry, at least for someone without a "healthy pregnancy and natural birth".

[mamakay]

Originally Posted by Peppermint

OK, here is what I find: (with a quick search)
http://www.madsci.org/posts/archives...8607.Me.r.html

http://www.path.sunysb.edu/coursemat...odlymphoid.htm

http://www.mfi.ku.dk/ppaulev/chapter32/kap32.htm

which all seem to agree with what I quoted, that the IgM *is* too big to cross the placenta. My issues are 2- I find MT to be very well-researched, and generally don't find her spouting things that aren't true, which leads me to the second part being, I don't know how to research this as well as I should, I suppose. All I can do is search google and see what comes up, I have found that I miss a lot when I try to look into things myself, and in the past others on this forum seem to be able to find the "other side" easier and help me see what I am missing.

I am simply a few weeks from having this injection again, and want to make the right choice. I am not having a "normal healthy pregnancy and intervention-free birth" so it really is more of an issue for me. One of the most convincing things I saw which made me re-think getting the shot, was the idea that it could hurt this baby, the one I am carrying *right now*, HE is my main concern, and I want to see him born healthy, and have a lot to consider with that.

This seems so different from all of the vaccines we discuss here, which, for me, have been easily proven not only harmful, but ineffective and unnecessary. I am feeling like this is not so cut and dry, at least for someone without a "healthy pregnancy and natural birth".

I gotcha.
MT is usually correct, but everyone makes mistakes sometimes.
I'm pretty good at "debunking" stuff...: ...so I'll see if I can help you out. Give me a few days to see if there's "another side" out there.

I have an immunologist friend who's sort of antivax, too, and I'll ask her if she knows what the deal is.

I'm Rh- myself, but only plan on having my one child I have, so I've never really looked at the issue that deeply before.

[maxmama]

Originally Posted by mamakay

Er, so have you ever read about the problem of adventitious agents in biologicals?

If so, what are your thoughts?

There's risk/benefit, like literally everything else. I'm more concerned about the known risks to, say, going into cardiac failure from a hct of 18 than I am about possible risks from transfusion. Ditto for RhoGam.

[Plummeting]

Originally Posted by iamleabee

The only antibody to cross the placenta is IgG. This is what the immune system eventually makes after an exposure to antigen, so that a second exposure has a rapid immunilogical response.
:
RhoGam is an IgM anti-D immunoglobulin that binds to the D antigen and eliminates it from the body, thus preventing the maternal immune system from seeing it and forming IgG antibodies against it. The difference is that IgM antibodies are too large to cross the placental barrier, and therefore cannot harm the fetus (they contain 5 subunits), whereas IgG antbodies are small and do cross the placenta and attack fetal RBCs.

:

IgM doesn't cross the placenta, right. But can you show me where you learned that RhoGam is IgM? I can't find any evidence to support that assertion.

[alegna]

Originally Posted by iamleabee

The only antibody to cross the placenta is IgG. This is what the immune system eventually makes after an exposure to antigen, so that a second exposure has a rapid immunilogical response.
:
RhoGam is an IgM anti-D immunoglobulin that binds to the D antigen and eliminates it from the body, thus preventing the maternal immune system from seeing it and forming IgG antibodies against it. The difference is that IgM antibodies are too large to cross the placental barrier, and therefore cannot harm the fetus (they contain 5 subunits), whereas IgG antbodies are small and do cross the placenta and attack fetal RBCs.

:

This:
http://www.rxlist.com/cgi/generic2/rhogam.htm

says that rhogam is IgG. Is there something I'm missing?

-Angela

[NinaBruja]

Originally Posted by iamleabee

The only antibody to cross the placenta is IgG. This is what the immune system eventually makes after an exposure to antigen, so that a second exposure has a rapid immunilogical response.
:
RhoGam is an IgM anti-D immunoglobulin that binds to the D antigen and eliminates it from the body, thus preventing the maternal immune system from seeing it and forming IgG antibodies against it. The difference is that IgM antibodies are too large to cross the placental barrier, and therefore cannot harm the fetus (they contain 5 subunits), whereas IgG antbodies are small and do cross the placenta and attack fetal RBCs.

:

this is what my friend told me:

Rhogam is IgG.
http://www.rxlist.com/cgi/generic2/rhogam.htm

eta: crosspost!

[alegna]

Great crossposting batman! Way to google the same link too!

-Angela

[mamakay]

Originally Posted by maxmama

There's risk/benefit, like literally everything else. I'm more concerned about the known risks to, say, going into cardiac failure from a hct of 18 than I am about possible risks from transfusion. Ditto for RhoGam.

So that part where they talk about covering up the "rather large number" of cases of contamination doesn't make you wonder what the actual risk/benefit ratio might be?
He even used the words "sooner or later the information will leak out".

I'm not generally one for conspiracy theories, but dang!
I mean, that's pretty darn bad.

In your mind, as long as the risk part is actively concealed from the public, it's just a "possible risk"? As opposed to a "known risk"?



I guess that's what they're going for...