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Question
Posted by: kristin | 2005/12/14

being rh-

i am rh- and had a pregnancy that was not full term. exactly when do i have to get a rhogam shot? i want my baby to be healthy

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Our expert says:
Expert ImageGynaeDoc

You should have had the Rhogam within 72 hours of the birth

Best wishes

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Our users say:
Posted by: lerita | 2005/12/14

Yor posting is a bit confusing. Did you have a pregnancy and lost the baby and is now pregnant again? Or were you never pregnant before and this is your first pregnancy?. Is your husband RH+ and you RH-?. If you had a previous pregnancy / miscarriage and your bloodtypes differed, yYou should have received your anti D injection just after you have given birth. If this is your first pregnancy, you should not worry, this injection will be given to you in the hospital. The rhesus inompatlibility only affects you with later pregnancy. Permit me to attach a previous posting to you regarding this mamter that one of our regulars wrote
What is referred to here is Rhesus factor incompatibility. It occurs when the mother has rhesus negative (ie Rh-) blood and the father has rh+ blood. The fetus then may have Rh+ blood. When Rh- blood comes into contact with Rh+ blood it recognises it as 'foreign' and will try to destroy it, so it makes antibodies against the 'foreign' invader. Rhesus incompatibility can happen when there is any bleeding during pregnancy, or due to an amniocentesis or CVS, or a MC. What happens is that the antibodies in the mothers blood can cross the placenta and attack the red blood cells in the fetus and that of course is not a good scenario. It can cause mild anaemia and jaundice, but at worst also stillbirth. These antibodies usually only form after the birth of the first baby, because the antibodies are manufactured in the mothers blood following the birth process. It is completely preventable: as it can be anticipated (knowing the mom's blood is Rh-), and the mom will be given an anti-D immunoglobulin injection within 72 h of any bleeding during or after pregnancy or else between week 27 and 28. It is the standard essential preventative treatment, and its lasts for 3 months.

If an anti-D injection wasn't given then the mothers blood can be tested for the presence of anti-D antibodies (Rh sensitization). If they are present, then it is a high risk pregnancy which needs to be followed by a qualified obstetrician. The fetus' blood also needs to be checked early in the second trimester to see if it is Rh+. If the fetus is Rh+, the number of antibodies (titer) in the moms blood needs to be monitored. If they are detected in small amounts, which do not rise, then its ok. If the titer does rise, then the fetus/baby will be monitored by taking cord blood samples and may need an intrauterine blood transfusion, and then a total blood exchange after birth. Treatment for Rh incompatibility has come a long way in the last two decades, and a good pregnancy outcome is quite possibile. There are two important take home messages:
1. if you are Rh-, then during your FIRST pregnancy you need to be treated with Anti-D.
2. If you were not treated, and were sensitized with you first pregnancy (ie Rh antibodies present) then you MUST make sure that you are treated by an obstetrician who specializes in high risk pregnancies.

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