RhoGAM - Uses, Side Effects, and Contraindications

Introduction:

The injection used to stop Rh (Rhesus) incompatibility from increasing during pregnancy is called RhoGAM. Antibodies in the shot (obtained from plasma donors) prevent the immune system from responding to the baby's Rh-positive blood cells. In other words, it prevents potential issues caused by two blood types mixing at any point throughout the pregnancy or delivery if the Rh incompatibility affects both the mother and baby. RhoGAM is administered into the arm or behind, like other shots.

What Is the Rh Factor?

Red blood cells, which transport oxygen throughout the body, frequently include a particular sort of protein on their surface called the Rh factor. But only some people possess it. An individual is Rh-positive if they possess the protein. If not, the Rh status is negative. Most people have the Rh gene. About 15 percent of white people, 4 to 8 percent of Black people, and 0.3 percent of Asians have a negative Rh factor. Rh negativity is not a disease; it typically has no detrimental effects on one’s health. However, it might impact one’s pregnancy.

What Does Rh Incompatibility Mean?

When a pregnant woman is Rh negative, and the unborn child is Rh positive, it is referred to as Rh incompatibility. During pregnancy or delivery, if maternal blood comes into contact with the baby's, the body may produce antibodies against the Rh factor. As a result, the immune system will launch an attack on those Rh-positive red blood cells, which could result in difficulties (particularly if they become pregnant again in the future). Because of this, the doctor will check the mother's Rh factor early in pregnancy.

What Effects Do Having an Rh-Negative Pregnancy Have?

The individual has an Rh factor mismatch if the mother is Rh-negative and the child's father is Rh-positive (or if the father's type is unknown). The mother's immune system might produce antibodies against the baby's blood cells if the baby has the same Rh-positive gene as the father. These antibodies start destroying the baby's blood cells if they return to them through the placenta. The antibodies may also cause the following effects:

• In the Baby: Rh-induced hemolytic illness may result in your infant from this. This illness can cause anything from moderate jaundice and anemia to intellectual impairment or even death.

• In the Mother: The antibodies will normally remain there for the remainder of one’s life. They might have an impact on the future children of the affected mother. They can also make it difficult to receive an emergency blood transfusion.

Does Pregnancy Require the RhoGAM Shot?

The shot is not required if the Rh test results are positive. However, the doctor will advise having the RhoGAM shot if the mother is Rh negative and the baby's father later tests Rh positive. The easiest method to avoid any potential issues from Rh incompatibility is to receive a RhoGAM injection. The mother's and baby's blood touch during labor and delivery shields the baby's red blood cells from damage and helps prevent issues connected to Rh in subsequent pregnancies. Speaking of subsequent pregnancies, it is imperative to receive the RhoGAM shot with every child unless the healthcare professional instructs otherwise if the mother is Rh negative. (If it is found that the infant is also Rh negative, the mother will not require the shot).

How Is a Mismatch in the Rh Factor Treated?

The doctor may advise an injection (shot) of a drug called Rho(D) immune globulin if the mother and the father of the child have an Rh factor mismatch. This medication is frequently referred to by RhoGAM, one of its brand names. The baby's risk of contracting a hemolytic condition can be decreased by receiving an injection properly during or after pregnancy. It is ideal to have a RhoGAM injection during pregnancy before the body starts to produce antibodies against the blood cells of the unborn child. It is often administered between weeks 26 and 28 of pregnancy. This medication, when injected:

• Prevents the body from producing antibodies against the unborn child's blood cells.

• Guards the infant against hemolytic illness brought on by the Rh.

• Aids in preventing the production of antibodies against the unborn child's blood cells throughout future pregnancies.

How Is RhoGAM Administered?

Depending on the indication and manufacturer guidelines, intramuscular (IM) or intravenous (IV) injection is used to administer RhIG to prevent Rh isoimmunization. A single dose should be administered prophylactically between weeks 26 and 28 of pregnancy and once more within 72 hours following the delivery of an Rh-positive infant. RhIG should be delivered within 72 hours and dosed following the quantity of RBC (red blood cells) exposure as per manufacturer recommendations for any known or suspected maternal exposure to Rh-positive RBCs or any incompatible Rh-positive blood product obtained. RhIG should be given to pregnant women every 12 weeks after the initial injection to maintain an adequate level of passively acquired anti-D antibodies.

What Are the Side Effects of RhoGAM Injection?

The shot of RhoGAM seldom causes moderate side effects. They may consist of the following:

• Soreness or rash on the injection side.

• Chills.

• Headache.

• Weakness.

• Fever.

• Dizziness.

• Infection.

• Hypertension.

• Drowsiness.

• Shivering.

• Diaphoresis (unusual sweating).

• Pallor (looking pale).

Is a RhoGAM Injection Necessary Following a Miscarriage or a Chemical Pregnancy?

When the mother's blood comes into contact with the baby's, as it can if the mother experiences a miscarriage or ectopic pregnancy, one should get the RhoGAM shot as a precaution; however, following a chemical pregnancy (an extremely early pregnancy loss occurs when a fertilized egg is implanted in the uterus but fails to develop properly. It typically happens between weeks four to five of the menstrual cycle); a RhoGAM injection is unnecessary.

What Are the Contraindications of the RhoGAM Shot?

Manufacturer-specific FDA (The United States Food and Drug Administration)-listed contraindications for RhIG include the following:

• RhIG should not be administered to patients who are Rh-positive since doing so could cause a hemolytic response.

• Sufferers of any human immune globulin product who have previously experienced severe reactions or anaphylaxis (a life-threatening allergic reaction).

• Patients at high risk for hemolysis (red blood cell breakdown), those with autoimmune hemolytic anemia, or those with preexisting hemolysis.

• Products containing RhIG, which may have trace amounts of IgA (immunoglobulin A), should be avoided by people with IgA deficiency and IgA antibodies.

Does RhoGAM Cause Toxicity?

Rarely do RhIG treatments result in severe and fatal toxicity. Immune thrombocytopenic purpura (a condition where the affected person's platelet count is low) patients should be closely watched to ensure that their hemoglobin does not drop by more than 1.6 ounce/gallon in the case of an overdose. Hemolytic responses may happen in inhibiting Rh isoimmunization if incompatible blood transfusions are given after extremely high doses of RhIG. Patients should be constantly watched for hemolysis symptoms and signs, and supportive care should be started as soon as symptoms appear.

Conclusion

RhoGAM is incredibly safe. It has been used for about 50 years and is advised for all pregnant women with RH-negative blood types. Even though RhoGAM is made from human blood, only a very small portion of it is used. There is a slim chance of contracting an infection like HIV or hepatitis via RhoGAM, although there are no reports of this ever happening. Additionally, there is a slim chance of developing an allergy. It is critical to recognize that the danger of developing Rh Sensitization is significantly greater than the chance of complications from the RhoGAM shot. Once that occurs, all future pregnancies risk the baby being severely ill or perhaps dying if the baby is RH positive. As a result, not taking RhoGAM is considerably more than taking RhoGAM.