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RhoGAM

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RhoGAM, RHO Immune Globulin, Rh Immune Globulin, RhoD Immune Globulin

  • See Also
  1. Rh Sensitization
  2. Hemolytic Disease of the Newborn
  3. Fetal hydrops
  4. Rhesus Blood Group
  5. Uterine Bleeding in Pregnancy
  • Indications
  1. Prevention of Rh Sensitization in Rh Negative mother (risk of Hemolytic Disease of the Newborn)
  • Contraindications
  1. Rh Positive patients
  2. Rh Sensitized patients
  • Mechanism
  1. Immunoglobulin Extracted from pooled human serum given to Rh Negative pregnant women
  2. Prevents maternal Antibody response to a fetus with Rh Positive RBCs, resulting in Rh Sensitization
    1. Rh Sensitization risks Hemolytic Disease of the Newborn and Fetal hydrops
  3. RHO Immune Globulin binds Rho Antigens that have crossed into maternal circulation
    1. Immunoglobulin binding of Rho Antigens masks them from maternal immune response
  • Dosing
  1. Timing
    1. Uterine bleeding or Trauma
    2. Routine scheduled dosing for Rh Negative mother
      1. Gestational age: 28 weeks
      2. Postpartum within 72 hours of delivery
  2. Uterine Bleeding in Pregnancy
    1. RhoGAM dose based on Kleihauer-Betke
    2. Give 300 mcg IM per 30 ml fetal whole blood or 15 ml pRBC
  3. No Uterine bleeding (routinely timed administration)
    1. Gestation under 13 weeks: RhoGAM 50 mcg IM
    2. Gestation over 13 weeks: RhoGAM 300 mcg IM
  • Adverse Effects
  1. Hypersensitivity Reactions (including Anaphylaxis)
  2. Hemolysis (if given to an Rh Positive patient)
  3. Bloodborne Communicable Disease
    1. As with all donor Blood Products, carefully screened in U.S. and exceedingly low risk
    2. Potential risk of Creutzfeldt Jakob Disease (or its variant)
  4. Injection site reaction
    1. Local swelling, warmth, induration, redness or mild pain
  5. Other less common effects
    1. Skin rash
    2. Myalgias
    3. Low grade fever
  • Resources
  1. RHO Immune Globulin - RhoGAM (DailyMed)
    1. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=d87e4d0b-2442-4135-b3f9-5c4f74845b87