RhoGAM

Aka: RhoGAM, RHO Immune Globulin, Rh Immune Globulin, RhoD Immune Globulin

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II. Indications

  1. Prevention of Rh Sensitization in Rh Negative mother (risk of Hemolytic Disease of the Newborn)

III. Contraindications

  1. Rh Positive patients
  2. Rh Sensitized patients

IV. 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

V. 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

VI. 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

VII. Resources

  1. RHO Immune Globulin - RhoGAM (DailyMed)
    1. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=d87e4d0b-2442-4135-b3f9-5c4f74845b87

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Related Studies

Ontology: Rho(D) Immune Globulin (C0073188)

Definition (NCI) An immunoglobulin blood product given to the pregnant mother that helps to prevent the Rh negative mother from developing an antibody response to the Rh positive blood cells of the fetus.
Definition (MSH) Immunizing agent containing IMMUNOGLOBULIN G anti-Rho(D) used for preventing Rh immunization in Rh-negative individuals exposed to Rh-positive red blood cells.
Concepts Pharmacologic Substance (T121) , Amino Acid, Peptide, or Protein (T116) , Immunologic Factor (T129)
MSH D018029
SnomedCT 49802003
CPT 90384, 90385, 90386
LNC LP66664-1, LP14598-4, MTHU027977
English Anti-D-Immunoglobulin, Rh Immune Globulin, Rho(D) Immune Human Globulin, Immune Globulin, Rh, Anti D Immunoglobulin, Globulin, Rh Immune, Rh o(D) immune globulin, Rh o(D) immune globulin (product), Rh o(D) immune globulin (substance), Rh<sub>o</sub>(D) immune globulin (product), Rh<sub>o</sub>(D) immune globulin (substance), Rh<sub>o</sub>(D) immune globulin, RHO D IMMUNE GLOBULIN, RHIG, Rh0 (d) immune globulin human, Rh0 (d) immune globulin, RHo (D) immune globulin, human Rho D immune globulin (medication), human Rho D immune globulin, HUMAN RHO(D) IMMUNE GLOBULIN, Human Rho(D) Immune Globulin, Rho(D) Immune Globulin [Chemical/Ingredient], Rh immune globulin, rho d immune globulin, anti d immunoglobulin, rh immune globulin, Human Rho(d) Immune Globulin, Rho(D) immune globulin, Human Rho(D) immune globulin, anti-D (rh) immunoglobulin, Anti-D (Rh) immunoglobulin, Rh>o<(D) immune globulin, Rh>o<(D) immune globulin (product), Rh>o<(D) immune globulin (substance), Rho(D) Immune Globulin, RHO (D) IMMUNE GLOBULIN,HUMAN, RHo (D) Immune Globulin
Swedish Rho(D)-immunglobulin
Czech imunoglobulin Rh, anti-D-imunoglobulin, Rho(D) imunoglobulin
Finnish Rho(D)-immunoglobuliini
Russian IMMUNNYI GLOBULIN RH, RH IMMUNNYI GLOBULIN, ANTI-D-IMMUNOGLOBULIN, IMMUNNYI GLOBULIN RHO(D), RH ИММУННЫЙ ГЛОБУЛИН, АНТИ-D-ИММУНОГЛОБУЛИН, ИММУННЫЙ ГЛОБУЛИН RHO(D), ИММУННЫЙ ГЛОБУЛИН RH
Spanish inmunoglobulina anti-Rh o (D) (sustancia), inmunoglobulina anti-Rh<sub>o</sub> (D) (sustancia), inmunoglobulina anti-Rh o (D), inmunoglobulina anti-Rh<sub>o</sub> (D) (producto), inmunoglobulina anti-Rh o (D) (producto), inmunoglobulina anti-Rh<sub>o</sub> (D), inmunoglobulina anti-Rh>o< (D) (producto), inmunoglobulina anti-Rh>o< (D) (sustancia), inmunoglobulina anti-Rh>o< (D), Anti-D-Inmunoglobulina, Globulina Inmune Rh, Globulina Rh Inmune, Globulina Inmune rho(D)
Italian Immunoglobulina Rh, Immunoglobulina anti-D, Immunoglobulina umana Rho(D), Immunoglobulina Rho(D)
German RHO D IMMUNGLOBULIN, Anti-D-Immunglobulin, Immunglobulin, Rh-, Rh-Immunglobulin, Rho(D)-Immunglobulin
Polish Immunoglobulina odpornościowa Rho(D), Globulina odpornościowa Rh
Japanese 免疫グロブリンRh, Rh免疫グロブリン, Rho(D)免疫グロブリン, 抗D免疫グロブリン
French Immunoglobuline anti-D, Immunoglobuline Rh
Portuguese Anti-D-Imunoglobulina, Imunoglobulina Rh, Imunoglobulina rho(D)
Derived from the NIH UMLS (Unified Medical Language System)

Ontology: RhoGAM (C0702053)

Concepts Pharmacologic Substance (T121) , Amino Acid, Peptide, or Protein (T116) , Immunologic Factor (T129)
MSH D018029
LNC LP64683-3
English RhoGam, rhogam, RhoGAM
Derived from the NIH UMLS (Unified Medical Language System)

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