Rhogam Shot Administered Late

Updated on March 14, 2010
R.C. asks from Hendersonville, NC
7 answers

Hi, I am asking this on behalf of my wife (and) I. We were pregnant (first time) with our first child earlier this year, however, we miscarried less than a month ago. We were heartbroken and shellshocked needless to say... upon visiting my wife's OB she said as a precaution (very subtly) we may draw some blood and need to give you a shot by next week. At the time we had not idea there were such complications with a RH negative woman conceiving with a Rh postive man. Long story short, we went home over the weekend and just (stayed by each other, praying and crying alone together) Our phones were silent and we practically were brain-numb for nearly a week. (Please don't think us terrible or irresponsible) we missed a week of calls from the OB that were saying my wife was Rh Negative and to come get the Rhogam shot. We finally got the message from a FULL voicemail box and rushed in that instance and received the shot. It had been a week and a couple days since the official miscarriage. upon talking with the doctor we went ahead and had more blood drawn to send off for antibody screening.

Finally my question... has anyone else had a similar thing happen to them i.e. had the Rhpgam shot administered later than the 72 hr window they have for it? What were the results/problems of the pregnancy/delivery? If any antibodies show up, are our chances of ever getting pregnant gone?
Thanks for your answers and prayers!

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So What Happened?

Sooo... the blood screening was done this past Thursday afternoon (11th) and the doctor told us that we would hear of the results by Friday (the next day). Well, we just got the call from the doctor today Tuesday (16th) and he said, "Not a single trace of antibodies in your blood!" God is good!! Having missed the RhoGAM for more than a week after the propsed timeframe, we were extremely worried about all of our future pregnancies. This news was an absolute answer to many prayers that have gone up from us and everyone we know! : ) Thank you all so much for taking the time to get on here and answer my question, you are ALL a blessing to those of us who need support!
Thanks,
Ryan & Amanda

More Answers

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H.J.

answers from Minneapolis on

I am sorry you are dealing with this! It is such a scary and hard issue to work with. Chances of getting pregnant again should be just fine. But you do need to make sure she gets tested to see if the real (life threatening antibodies) are in her system before trying again. It can take a while for them to leave her system if she does produce her own antibodies but the goal is that the shot (with harmless antibodies) gets her system to think they are already there and not produce them. That is why there is a window. Now the Key and I know it can be hard is if she does end up producing her own antibodies that are harmful you do NOT want to get pregnant until they are gone. This is huge. Her body will attack the baby if it has rh+ blood which is a pretty high chance that it will. This is crucial to not get pregnant until it is gone. If she has the bad antibodies and gets pregnant lots of in utero blood transfusion can be in store to keep the baby alive. There is lots of information on this and It has been a few years since I got the first round when I was pregnant with my daughter my first and experienced issues with being RH - both of my first two kids ended up being RH + and we are not sure on our third yet but it is much more common then RH-. If you have a good OB/Midwife they can step you through this process. There is a good chance that all will be fine, but please make sure to take the precautionary steps in preventing a high risk pregnancy which is something emotionally neither of you need after a miscarriage. I would double check with the doctor but I think it was that it can take up to three years for her system to clear out. Seems like a long time but worth the wait if she did produce her own. I hope that this is not the case though.

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B.K.

answers from Missoula on

I wouldn't worry about it. The importatn thing is that she got the shot. I am Rh negative too and as along as you get the shot, you're all good. Even if it's late. If it was a problem, your doctor would have informed you. Sorry about what happened.

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S.G.

answers from Philadelphia on

I am Rh- and have suffered through a miscarriage. Unfortunately, I have not been in your shoes, as far as missing the RhoGAM shot. I googled it and found this article. Most of it is just background info on Rh factors, what happens when there is incompatible blood, what happens if the blood mixes, etc. I think the very last paragraph will answer your question about conceiving again and carrying to term. I wish you the best of luck and just remember that you are not alone. It's only after you experience a miscarriage do you realize how many other moms/couples out there have gone through the same thing. You can always find a shoulder to cry on and a friend to confide in. Good luck to you and God Bless! *hugs*

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If you are Rh-negative, most doctors will advise that you get a RhoGAM ® shot after a miscarriage, ectopic pregnancy, or other pregnancy loss. Getting a RhoGAM or other Rh immune globulin shot is a precaution against a situation called Rh incompatibility, which could affect future pregnancies and cause hemolytic disease in the newborn.

Rh factor is a protein that the majority of people carry in their blood. Roughly 85% of the population is Rh-positive, and Rh status is genetically determined.

In women who are Rh-negative who have Rh-positive partners, the baby has at least a 50% chance of being Rh-positive (Rh-positive status is a dominant genetic trait). Women who are Rh-positive and women who are Rh-negative with Rh-negative partners do not need to worry about RhoGAM shots because Rh incompatibility is impossible. In first pregnancies, Rh sensitization is rarely a problem because the mother’s blood and the baby’s blood typically do not interact directly until delivery -- but if Rh-positive blood (such as from the baby) enters the Rh-negative mother’s blood, her immune system may develop antibodies against Rh factor. If these antibodies then enter an Rh-positive baby’s bloodstream, the antibodies can begin to attack the baby’s blood, causing jaundice or more severe symptoms if left untreated.

RhoGAM pre-stocks the woman’s blood with the antibodies to the Rh factor protein, and this prevents the woman’s immune system from needing to create antibodies to Rh factor in the event of encountering Rh-positive blood.

Injecting the antibodies is safer than risking sensitization, because RhoGAM antibodies eventually clear the mother’s bloodstream, meaning that if the mother’s blood mixed with the baby’s in the future, her immune system would not have learned to create antibodies against Rh factor and the baby would not get anti-Rh antibodies. If a mother’s blood is sensitized to Rh factor, the sensitization may be permanent and she risks delivering anti-Rh antibodies to her future babies.

As a part of the blood testing in standard prenatal care, most doctors check the woman’s blood type in order to identify women for whom Rh incompatibility is a concern. Originally, recommendations were to give the injections to women who had given birth. The recommendations then changed to include a RhoGAM shot around 28 weeks of pregnancy. Although few studies exist on using Rh immune globulin for first-trimester miscarriages, many doctors do recommend them because of a theoretical risk of sensitization after miscarriages with the idea that the potential benefits outweigh the minimal risk. The shot needs to be given within about 72 hours of the onset of the miscarriage in order to be effective.

If you did not get a RhoGAM shot, do not panic -- remember that the risk of sensitization after a miscarriage is relatively small. However, you should inform your doctor of your concern. Your doctor can order a blood test to check your Rh sensitization status. In the event that you did develop anti-Rh antibodies, treatments for Rh incompatibility do exist and your doctor will know to observe your future pregnancies closely for signs of problems so as to intervene early if needed.

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E.M.

answers from Louisville on

Im not quiet sure i understand most women dont get the rhogam shot until they are around 20 weeks.

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J.M.

answers from Phoenix on

Hi, I am very sorry that you are having to deal with this but being Rh- is a very common thing. I am Rh- and have gone through all the shots from start to finish and even after pregnancy you have to get shots to prevent it from your next child. Both of my children were Rh+ so it was critical for me to receive the shots so my antibodies didn't attack my child. Don't stress out about it. Get your shots and everything should be fine. I ended up having two healthy girls and now I am going on my 3rd pregnancy. Good luck and hopefully after all these comments the both of you can get some rest.

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M.W.

answers from Huntington on

In most normal miscarriages and births, there is normally no blood mixing, however, there is a chance that the two circulations could mix during the process, which is when the antibodies are made and trouble begins, esp if drugs or instruments were used. If your fetus had RH neg. blood, no antibodies are made during its passage. Even if your fetus was RH pos. there are sometimes no blood mixing and therefore no antibodies made. At this point, you would need another blood test (titre level) to see if you've been sensitized to the RH factor. If you have, the RhoGam shot will not work, as it only prevents you from making the antibodies in the 1st place. It can't eradicate them once they're there. For maximum sucess, it should be given within 48 hours of the "event" (the event can be birth, miscarriage or any bleeding during pregnancy.) but often getting it within 72 hours is sufficient. If you haven't developed antibodies by now, chances are you won't, however you may want to take the shot anyway, to be sure.
If you are indeed sensitized, that won't keep you from getting pregnant, it just makes it riskier. Each pregnancy has a 50/50 chance of producing an RH neg baby, which will not be affected or an RH pos baby which will.

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M.B.

answers from Medford on

Hi. I am checking on this and will get back to you.

My great friends have this answer.
Dear M., Since Doug is not computer savvy, I will respond to your e-mail as best I can. Actually, since Doug practiced pediatrics, RH Negative pregnancies have greatly advanced in treatment. His advice after reading this, is to go on from where the couple is now. You can't turn back the clock. That is, they are doing all that they know to do as of NOW. They have followed up with a Rhogam Shot, albeit over a week after the miscarriage. Doug says that they should follow the Obstetrician's advice now as to the shots for further attempts at having a child . etc. And by all means, don't give up! A miscarriage is a sad and unfortunate occurrence, but many, many countless people have gone through this----and still have had large families. They will have to follow orders carefully before, during and after getting pregnant because of this factor. Very likely it will not have mattered that the shot was given a little late. At least it was given! Go from there!

But let me encourage you as well. I lost four babies by miscarriage, but praise the Lord, I have four wonderful live and healthy children-----now grown adults. I was not one with the Rh-negative blood, but with the first pregnancy, the baby developed surprisingly in my fallopian tube, ruptured, and I'm thankful to be alive. With only one tube left, the Head OB at the University of Maryland Hospital said to "never have children". However-----we were determined to try for more! I had seven more pregnancies on the one remaining tube. I'm writing this, simply to give you courage to carry on. Don't give up!

Also-----when Doug practiced Pediatrics in Grants Pass, he was the first Pediatrician in the area who could successfully transfuse the RH factor babies, replacing all of baby's blood. He had learned this technique at the Children's Hospital in Pittsburgh where he specialized. One baby had to be totally transfused 7 times. The baby lived! Medicine has come a LONG, LONG WAY since those days-----and the Rhogam Shot had never been heard of. I am confident that the couple's next attempt will be more successful.

THIS DOES NOT directly answer your friend's question, but I trust there is some encouragement here. We can't undo what's done----we have to go on from where we are. Don't give up! Love, Sue

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