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Old 08-26-2013
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ObGyn Anti Rh Ig prophylaxis

Is Rh isoimmunization prophylaxis (Rh D Ig) given to all mothers at 28 weeks and within 72 hours of delivery? Or just to Rh negative mothers, and previous vaginal bleeding/abortion/amniocentesis mothers?
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Old 08-26-2013
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only if the mother is rh negative and d fetus is rh positive [even in case of amniocentesis or abortion...
not every pregnant lady
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Old 08-26-2013
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RhoGAM

RhoGAM ABCD Mnemonic

These were pretty helpful
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Old 08-26-2013
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Quote:
Originally Posted by drsrb View Post
only if the mother is rh negative and d fetus is rh positive [even in case of amniocentesis or abortion...
not every pregnant lady
Ugh! So let's sum up...

-Who get's prophylaxis? 1 or 2 or 3
1- All Rh negative mothers?
Or
2- All mothers with an associated event (fetomaternal hemorrhage, CVS, amniocentesis, abortions, miscarriages, etc)?
Or
3- Mothers who are BOTH Rh negative AND with an associated event (fetomaternal hemorrhage, CVS, amniocentesis, abortions, miscarriages, etc)?

-When do they get it?
Immediately after the event, at 28 weeks, and within 72 hours of delivery?
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Old 08-26-2013
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1. rh negative mothers with rh positive fetus.[if the fetus is rh neg too then there is no point of rhogam]
2.again if the mother is rh negative only then ..so that makes this option 3..;p
so basically acc to me n i also consulted kaplan and checked some sources on net..it all comes down to rh status of the mother ...rh neg mom with rh positive fetus u give rhogam!!!
n d rosette test[qualitative test] n kleihauer betke test[quantitative test] are used to look for fetomaternal blood mixing.
300 micrograms of rhogam neutralizes 15 ml of fetal rbcs.
In case it seems more mixing of blood has occurred,then the amount is measured via kleihauer betke test..n according to that number of vials of rhogam required are calculated and administered.
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Old 08-26-2013
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Rh + mother and/or positive antibody titres (i.e more than 32)=
-NO PROPHYLAXIS (no rhogam)
-Do MCA Doppler:
If it shows bad blood flow (less then 1.5) then do intrauterine infusion.
If it shows good blood flow (more than 1.5) then check the fetal hct. If the hct is bad (less than 30%) then do intrauterine infusion. If the hct is good (more than 30%) then follow up.

Rh - mother and negative antibody titres (i.e less than 16)=
-GIVE PROPHYLAXIS (yes rhogam)
-If there is no associated event (fetomaternal hemorrhage), then give a standard dose of rhogam at 28 weeks and within 72 hours of delivery
-If there is an associated event (fetomaternal hemorrhage), then give a dose of rhogam based on rosette&kleihauer test, at the event, at 28 weeks, and within 72 hours of delivery
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