RH- pregnancy & rho-gam: anyone NOT get it/getting it? - Mothering Forums

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#1 of 65 Old 05-11-2007, 07:40 PM - Thread Starter
 
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Im not sure if this is the right place to post this, so if not, mods please feel free to move.


I am now about 13 weeks into my third pregnancy. I've had Rho-gam in the past but has since become aware of the risks involved. I will not get the 28 injection but I am still unsure about the postpartum one. We want more children, but the Rho-gam is not a cure all without risk/cost. I have read that the risk are somewhat low (1 in 4000) of having a baby die as a result of not getting the Rho-gam... Just wondering what other mothers in my shoes have done.
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#2 of 65 Old 05-11-2007, 08:01 PM
 
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What risks are you worried about?

I've gotten it during every pregnancy and my loss. My kids are all O- so far so I haven't needed rhogam after delivery. My Dh is O+ so it is a possibility that this baby or the one we loss could be positive. Do you know what kind of blood your husband has?
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#3 of 65 Old 05-11-2007, 08:27 PM
 
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I hadn't heard about any risks involved with the Rhogam shot. I'm A-, but DH is O-, so I don't have to get the shot (I decline it because it's just totally unnecessary in our case. If DH were +, I would get the shot).
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#4 of 65 Old 05-11-2007, 09:49 PM - Thread Starter
 
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Rho-gam is a blood product and carries the risk of viral infection. They currently screen for the viruses they can detect, but there are others such as new variant Creutzfeldt Jakob disease (the human "mad cow" disease) that they have no way to test for. This is one one example of one known virus. No one really knows what or how many others there are out there. There are also some studies that suggest risks including immune system compromise & potential reproduction problems for girl babies exposed to Rho-gam in utero.


I am O- and my husband is O+. Our son was born O+
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#5 of 65 Old 05-11-2007, 10:40 PM
 
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I'm RH-, I had Rhogam with DD1, with DD2 I didn't want it. I chose not to even find out what blood type DD2 was at birth because either way I wasn't getting Rhogam. I later found out during one of her hospitalizations that she was B-. Read Sara Wickham's book "Anti-D in Midwifery".

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#6 of 65 Old 05-12-2007, 02:12 PM
 
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I am in my 6th pregnancy(lost my third through m/c), I had the shots during my pregnancies with my first two, and after with the first two, no shot after my loss(not sure why they didn't give it to me), then got the shot after my third delivery(but not during pregnancy). I declined the shot after my last pregnancy/delivery. I felt like my risks were pretty low, no birth trama, no one yanking on the cord, etc, and I thought it was my last pregnancy. LOL Surprise baby #5 is coming, and my antibodies are fine, and I won't be getting the shot this time either, unless there is trauma.

I need to check out that book too.
Oh, and I am A- and my hubby is A+ all of my kids so far have been A+

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#7 of 65 Old 05-12-2007, 02:18 PM
 
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I'm A+ and DH is O-. I didn't get it with DD and I didn't get tested for it. She was my first and I know it's not a concern then. We won't be getting tested for this one or getting the shot. Ahhh the joys of a UP/UC.

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#8 of 65 Old 05-12-2007, 03:56 PM - Thread Starter
 
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The biggest reason I am posting is that my doc seems to think that if I dont have the shot I will have a Hemolytic baby in the future. While I do agree that there is a chance, I don't believe the chance is great enough to risk getting the Rho-gam.


I do want to say that if I did have a major trauma prior to birth or complications during the birth I would concider depending on the severity. Basically what I dont want to do is "routine" injections.
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#9 of 65 Old 05-12-2007, 04:00 PM - Thread Starter
 
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Quote:
Originally Posted by OtherMother'n'Madre View Post
I'm A+ and DH is O-. I didn't get it with DD and I didn't get tested for it. She was my first and I know it's not a concern then. We won't be getting tested for this one or getting the shot. Ahhh the joys of a UP/UC.


They would not give you Rho-gam. Rho-gam is only for Rh- women. The father's blood type does not matter. In a Rh- pregnancy, your body treats the +s as an outsider and attack causing death & diease in the baby. (Assuming the baby is + and you have been sensitized)
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#10 of 65 Old 05-12-2007, 04:05 PM
 
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Originally Posted by SuperMoM2GTO View Post
They would not give you Rho-gam. Rho-gam is only for Rh- women. The father's blood type does not matter. In a Rh- pregnancy, your body treats the +s as an outsider and attack causing death & diease in the baby. (Assuming the baby is + and you have been sensitized)

I know this. I was just sharing our situation. I have never been tested to know if I was RH-.

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#11 of 65 Old 05-12-2007, 05:49 PM
 
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If you are A+ then you certainly aren't RH-.

Mom of 3 sons and one daughter
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#12 of 65 Old 05-12-2007, 09:57 PM
 
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Originally Posted by SuperMoM2GTO View Post
The biggest reason I am posting is that my doc seems to think that if I dont have the shot I will have a Hemolytic baby in the future. While I do agree that there is a chance, I don't believe the chance is great enough to risk getting the Rho-gam.


I do want to say that if I did have a major trauma prior to birth or complications during the birth I would concider depending on the severity. Basically what I dont want to do is "routine" injections.
Your plan sounds perfect to me.

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#13 of 65 Old 05-12-2007, 10:12 PM
 
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What are the supposed dangers of the rho-gan injection? I have gotten them w/ all 4 of my pregnancies,no problems.
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#14 of 65 Old 05-12-2007, 10:21 PM
 
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Dangers of rhogam injections: there may be mercury, i.e., thimerasol, used as a preservative, in the container. There may be an infection at the site of injection, always a possibility. Rhogam is made from human blood product which may contain HIV, hepatits, and variant Creutzfeldt Jakob disease; these are not diseases a new mother should have to deal with.

Furthermore, why get an injection that has the possibility of killing the baby you are carrying to protect the next baby you will have if you do not know if you are even going to have another baby, but YOU do KNOW you are having the baby you are carrying...does that make sense?

Why get an injection at all? Wait till the baby is born and then decide based on the results of a cord sample.

Furthermore, the typical protocol for this procedure does not include checking the blood type of your partner. Why? If your partner is Rh-, there is no reason to get the rhogam. The reason your partner's blood type is not checked is because most doctors entertain the outside possibility that the baby may not be his.

I had four children at home, am O- and I never got rhogam with any of them because I refused it. No problems here either.

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#15 of 65 Old 05-12-2007, 10:37 PM
 
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Originally Posted by applejuice View Post
Dangers of rhogam injections: there may be mercury, i.e., thimerasol, used as a preservative, in the container. There may be an infection at the site of injection, always a possibility. Rhogam is made from human blood product which may contain HIV, hepatits, and variant Creutzfeldt Jakob disease; these are not diseases a new mother should have to deal with.

Furthermore, why get an injection that has the possibility of killing the baby you are carrying to protect the next baby you will have if you do not know if you are even going to have another baby, but YOU do KNOW you are having the baby you are carrying...does that make sense?

Why get an injection at all? Wait till the baby is born and then decide based on the results of a cord sample.

Furthermore, the typical protocol for this procedure does not include checking the blood type of your partner. Why? If your partner is Rh-, there is no reason to get the rhogam. The reason your partner's blood type is not checked is because most doctors entertain the outside possibility that the baby may not be his.

I had four children at home, am O- and I never got rhogam with any of them because I refused it. No problems here either.
Thanks for the info. I am O-, hubby is O+, and all 3 of the kids were O+. Got it w/ this pregnancy,too already, as I had some major bleeds due to a previa.
Sure glad none of the things you mentioned ever happened here!
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#16 of 65 Old 05-12-2007, 10:41 PM
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I would love to see the study or other published evidence that shows that Rhogam injection has killed (or could kill) babies.

There have been no confirmed cases, ever, of anyone getting mad cow or any other communicable disease from Rhogam.

No treatment is without risk. The antibodies in Rhogam can be dangerous for Rh+ babies, though generally not as dangerous as an unchecked natural immune reaction to Rhesus factor is. In the case of Rh- women with Rh+ partners, choosing to decline treatment also carries significant risk.

It is routine practice for doctors not to check the father's blood type, for the reason applejuice stated. If your your partner and your partner's blood type are known, and he is Rh-, a reasonable physician will agree that there is no need for the shot. Rhogam has no impact whatsoever on Rh- babies anyway - it provides antibodies to an antigen Rh- individuals don't carry.

Anecdotally, it's possible to find many Rh- women who have had multiple children without either Rhogam or problems. As the frequency of Rhagam use increases, it's easy to focus on those individuals who didn't have the medication and also didn't have a problem. In the past, it was common for Rh- women with Rh+ partners to have one healthy baby followed by a series of brain damaged and stillborn babies.
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#17 of 65 Old 05-12-2007, 10:49 PM
 
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The problem with Rh babies happened because of the early cord cutting. The baby's blood was still in the cord, but the obstetrician cut the cord soon after birth instead of letting the baby take the rest of its blood in...the blood in the cord went to the mother and the mother began to make antibodies against the baby's blood cells. This can also happen in an ABO incompatibility.

The more careful road would be to wait for the cord to stop pulsing, then cut the cord, take a sample of the cord blood, and a sample of the mother's blood, send the samples to the lab to check for titres and then give the rhogam shot within 72 hours.

The reason not taking the rhogam shot worked for me is because I am O- and my DH is O+, but I have a compensating factor, the DU or Duffy factor in my blood. My midwife explained this to me. Few people I have discussed this with IRL know what I am talking about. BTW, my sister had a placenta previa with many bleeds also and she never received a rhogam shot with her children, both caesarean.

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#18 of 65 Old 05-12-2007, 10:50 PM
 
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I have to point out something...

From everything I know of CJD (Nursing school, Surgical tech school and a friends father passing away form it) it is NOT transmissible vis blood products. The most "common" way it is transmitted is via things involving the nervous system (i.e. surgical instrumentation). Also, CJD is NOT a virus, it is a prion. VERY different story (they are not able to be killed by pretty much anything we have including heat sterilization or chemicals)
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B

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#20 of 65 Old 05-13-2007, 01:12 AM
 
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Can anyone give me information about the pros/cons of prenatal Rhogam? I'm supposed to get it at my next appointment.

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#21 of 65 Old 05-13-2007, 01:27 AM
 
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I have the negative factor as well and plan on getting the shot because my midwife says i should at 28wks and postpartum. She said I won't be able to have kids in the future and if I manage to give birth again they would be "horribly deformed". So, I'm getting it done. I don't want to risk my future pregnancies....but I'm confused. I would like to know the pros/cons too.

And is it a MUST that I get it at 28wks???

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#22 of 65 Old 05-13-2007, 10:45 AM
 
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The shot given at 28 weeks is a "just in case" shot. It is given "in case" you have an undetectable microbleed which causes your baby's blood to mix with your own & set up an antibody reaction. If your baby is rh neg you don't need the shot but you don't find out blood type until after the birth so the shot is given regardless. You might also get the shot if you have obvious bleeding before 28 weeks as that might indicate mixing of mother & baby blood & possible sensitization.

As pp have suggested, there are risks either way - with getting the shot prenatally and with not getting the shot prenatally. It's a little more clearcut after birth since you can type the baby and know if they are rh neg or rh +.

There are other countries where the prental shot isn't given unless there is a trauma. It would be interesting to see if their sensitization rates are any higher than here. But I don't know of a resource to find that information.

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#23 of 65 Old 05-13-2007, 11:49 PM
 
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jazzybaby9 - I am Rh-, and I am pretty strongly in favor of Rhogam, but I think your midwife is being inappropriately alarmist, particularly about the 28 week shot.

If you are sensitized to Rh factors, any future pregnancies you have involving Rh positive babies would go badly (risk of fetal brain damage and death), but there is no guarantee that this pregnancy will sensitize you. Even if your partner is Rh positive, the baby might be Rh negative, and if this is the case, there's no need for Rhogam at all.

The 28 week shot is a "just in case" thing, intended to protect you from sensitization in the event that you experience some kind of pregnancy related traumatic injury. Based on the fact that Rhogam shots used to be given after birth, I presume that they could just as effectively give you Rhogam *after* such a trauma if it occurred, although I suppose it's possible that they might miss it in the rush of things surrounding treatment of traumatic injury - the ER docs might not identify you as Rh- or what you have you. Then again, you can buy an ID tag with your name, emergency contact numbers and blood type on it for cheap, EMTs and doctors do look at and for them, and they are absolutely devoid of disease risks.

I am very comfortable with Rhogam. I believe it to be safe. In my case, however, it turned out to be utterly unnecessary - my son is Rh negative. I don't regret having the 28-week shot, but you should be aware that you are probably okay passing it up (barring traumatic injury, in which case, any doctor aware of your Rh status would probably give you another shot of the stuff anyway). If, when your baby is born, he or she turns out to be Rh positive, you can get the shot then. You can even spare your baby the blood typing and get the shot post-partum when there is no chance of risk to the fetus.

Your midwife needs to chill.
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#24 of 65 Old 05-14-2007, 12:41 PM
 
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Although, as I posted earlier, I won't need the shots because my DH, who is most certainly the father of my children , is also Rh-. Both my midwife from the last pg and my OB from this pg are comfortable with that.

If he were Rh+, I would get the shot. I would much rather face the risks myself, as a healthy adult, than subject any future children of mine to the possible complications of me not getting the shot. The risks seem to me to be minimal, and far outweigh the possible risks of not getting it.
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#25 of 65 Old 05-14-2007, 01:48 PM
 
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Jsut to make sure that I understand this correctly. All of the following are assuming that I KNOW that the babe is my husbands

We are both +, there is no need for Rhogam.
I am -, he is +, the baby could potentially be +, potential need for Rhogam.
I am +, he is -, the baby could potentially be +, no need for Rhogam.
We are both -, there is no need for Rhogam.

Is that right, or have I missed something?

Thanks!

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#26 of 65 Old 05-14-2007, 02:12 PM
 
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Quote:
Originally Posted by earthymama2b View Post
Jsut to make sure that I understand this correctly. All of the following are assuming that I KNOW that the babe is my husbands

We are both +, there is no need for Rhogam.
I am -, he is +, the baby could potentially be +, potential need for Rhogam.
I am +, he is -, the baby could potentially be +, no need for Rhogam.
We are both -, there is no need for Rhogam.

Is that right, or have I missed something?

Thanks!
Both +, both -, you + him - = no rhogam.

You - him + potential need for rhogam.

Yep, you've got it!
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#27 of 65 Old 05-14-2007, 02:17 PM
 
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I got it already b/c my RH is negative and DH's is positive and I had some bleeding in the first trimester. I will have another shot in a couple of months as well.

I trust my midwife and think that in my case, the potential benefit of Rhogam outweighs the risk.
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#28 of 65 Old 05-14-2007, 02:39 PM - Thread Starter
 
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Your right, CJD is a prion, my mistake. But it still can and is passed through blood. The fact that it is a prion makes it all the more worst. There is no cure and no way to screen. It bascially just eats away at your brain and you die.

Yes I do see that the risk of getting CJD is *probably* smaller then the risk of being sensitzed BUT even if I was sensitzed I could in theory still carry a child to term or near term and with the medical advancments today the baby would have a chance at life (assuming a problem) Is this the route I'd perfer to go? No, but atleast I wouldn't be dieing and the child/children I aready have would still have their mother. These are both extreme examples but Rho-gam and the RH factor are not easy for anyone invloved. Its kinda damned if you do, damned if you don't.

Im entering into the land of a possible rh sensitization. Just kinda wondering other womens experiences with being rh-, partner rh+ and not getting Rho-gam. Maybe I should have titled my post differently?

Either way, thank all you ladies for you quick and honest posts
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#29 of 65 Old 05-14-2007, 03:12 PM
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Supermom, I'm sorry if you're not getting exactly what you want to get out of this thread. I wanted to clarify though:

The risk of CJD from Rhogam is *entirely* a hypothetical one. No cases of CJD have ever been linked to Rhogam.
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#30 of 65 Old 05-14-2007, 03:24 PM
 
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I got it during my first pregnancy because I'm O- and my dh is O+. Our dd was also O- so I didn't get one after. Because she is negative I know for sure that my dh carries the gene for Rh-. Therefore I know that our future children have a 50/50 shot of being negative also.

My second pregnancy I m/c and hemmoraged so I had one after.

I think that if I were to have any bleeding episodes during this pregnancy I would accept one prenatally, but if everything goes well I will decline the prenatal one.

If our baby turns out to be + after the birth I will accept it too. I don't think the extra half percent or so of protection the prenatal shot will give is worth either the expense of the shot or the worry about what the consequences could possibly be for a rh- child.

Heather Mike Married 8/1/99 Mom to Charlotte Aug 04, Nov 06, and Katherine Oct 07
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