RhoGAM is a prescription medication used for the prevention of Rh incompatibility. It is purified from human plasma and is manufactured by KEDPLASMA LLC. RhoGAM is administered by injection into the muscle (intramuscular).
What is Rh?
Rh factor, or Rhesus factor, is a type of protein on the surface of the red blood cells. It is similar to A, B, O, or AB blood types, which indicate different types of protein that are present on red blood cells. If a person is Rh positive, that person has Rh protein on the surface of red blood cells; if not, that person has Rh negative blood type. The majority of people (up to 85%) are Rh positive, meaning about 15% of population are Rh negative.
What is Rh incompatibility?
Rh incompatibility happens when the blood of an Rh negative person is exposed to Rh positive blood and antibodies develop. These antibodies will bind to Rh protein and destroy red blood cells. Situations where this can happen include blood exposure or a mom with Rh negative delivers an Rh positive baby.
What is actually happening?
The body of Rh negative person will develop antibodies against the protein that it does not have – Rh protein along with red blood cells. However, the process of developing antibodies does not happen immediately after exposure. For this reason, a mom with Rh negative may deliver her first Rh positive baby without any medical issues, unless she was exposed in the past (for example, abortions or miscarriages).
If Rh incompatibility happens, the unborn baby will be affected. Since the baby’s red blood cells are destroyed by the mom’s antibodies, bilirubin – a chemical from broken red blood cells – will build up in blood stream. High levels of bilirubin affect the liver. One noticeable symptom is jaundicing (the yellowing of skin and sclera).
How can this be prevented?
Because of good prenatal care, the problem is happening less now. Early blood type checking and monitoring are the key to prevention. Once the condition is diagnosed, the mom will be injected a special immune globulins – RhoGAM, which help prevent the development of Rh antibodies.
When does the mom need a RhoGAM injection?
There are certain situations that RhoGAM injection is needed, including:
- After an Rh-negative mom delivers Rh-positive baby.
- At 26-28 weeks of pregnancy, if indicated.
- Bleeding (maternal or fetal) during pregnancy.
- Ectopic pregnancy (pregnancy outside of the uterus).
- Loss or threatened loss of fetus at any stage of the pregnancy.
What are the risks for RhoGAM injection?
- Allergic reaction may occur, so the mom should be monitored at least 20 minutes after injection.
- The most common side effect is injection site reaction (swelling, hardening, redness, and pain). Some patients report light fever as well.
What is additional information the doctor should know when a person receives RhoGAM?
If a patient has:
- A known severe reaction or allergy with human immune globulin
- Immunoglobulin A (IgA) deficiency
- Received certain vaccines (for example, live vaccines). These vaccines may not work well with RhoGAM.
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PharmD Candidate 2021
Temple University School of Pharmacy
Kaneshiro, Neil K. “Rh Incompatibility: MedlinePlus Medical Encyclopedia.” MedlinePlus, U.S. National Library of Medicine, 6 Mar 2019, medlineplus.gov/ency/article/001600.htm. Accessed August 14, 2020.
RhoGAM, Kedrion Biopharmacy Inc., www.rhogam.com/. Accessed August 14, 2020.
Slightham, Cindie. “Rh Incompatibility: Symptoms, Diagnosis & Treatments.” Healthline, Healthline Media, 23 July 2018, www.healthline.com/health/rh-incompatibility. Accessed August 14, 2020.