Overview
Why Rh(D) Immune Globulin Is Given
An Rh negative patient can feel well while fetal red blood cells are quietly priming an immune response.
REx-PN
REx-PN
An Rh-negative patient can feel well while fetal red blood cells are quietly priming an immune response. When Rh-positive cells enter maternal circulation, anti-D antibodies may form; in a later pregnancy, immune IgG can cross the placenta and destroy Rh-positive fetal red blood cells. Rho(D) immune globulin (RhIG; RhoGAM is a brand name) supplies temporary anti-D before maternal immune memory is established. The bedside question is therefore not simply, Is this patient Rh-negative? Ask instead: Is the patient Rh-negative, not already alloimmunized, and has a potentially sensitizing exposure occurred? A 30-week patient who already received routine prophylaxis at 28 weeks presents after abdominal trauma. The earlier dose does not automatically cover this new exposure. The event, timing, maternal antibody status, and fetal or neonatal Rh status must be reassessed.
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