Rho(D) immune globulin: Difference between revisions
No edit summary |
|||
| (2 intermediate revisions by 2 users not shown) | |||
| Line 6: | Line 6: | ||
==Adult Dosing== | ==Adult Dosing== | ||
===[[Vaginal bleeding in pregnancy (less than 20wks)|1st Trimester (<13weeks) Vaginal Bleeding]]=== | ===[[Vaginal bleeding in pregnancy (less than 20wks)|1st Trimester (<13weeks) Vaginal Bleeding]]=== | ||
* | *50 microgm IM<ref>RhD alloimmunization: Prevention in pregnant and postpartum patients. Uptodate. Accessed 2/4/21</ref> | ||
**There is no harm in giving the standard 300 microgram dose, which is more readily available | **There is no harm in giving the standard 300 microgram dose, which is more readily available | ||
===[[Vaginal bleeding in pregnancy (greater than 20wks)|2nd & 3rd Trimester Vaginal Bleeding]]=== | ===[[Vaginal bleeding in pregnancy (greater than 20wks)|2nd & 3rd Trimester Vaginal Bleeding]]=== | ||
*300 microgm IM once and send Kleihauer-Betke test | *300 microgm IM once and send Kleihauer-Betke test | ||
| Line 25: | Line 26: | ||
==Indications== | ==Indications== | ||
*For fetal maternal hemorrhage | *For <b> risk</b> of fetal maternal hemorrhage, such as blunt abdominal trauma | ||
*Risk = >4-12wks | *Risk = >4-12wks | ||
*Duration effect: 12wks | *Duration effect: 12wks | ||
Latest revision as of 11:48, 26 December 2021
General
- Type: Immune Globulin
- Routes of Administration: IM, IV
- Common Trade Names: RhoGAM, WinRho
Adult Dosing
1st Trimester (<13weeks) Vaginal Bleeding
- 50 microgm IM[1]
- There is no harm in giving the standard 300 microgram dose, which is more readily available
2nd & 3rd Trimester Vaginal Bleeding
- 300 microgm IM once and send Kleihauer-Betke test
- Within 72hrs give additional 300 microgm/15 ml Rh-positive blood
Pediatric Dosing
- Same as adult dosing above
Special Populations
- Pregnancy Rating: C
- Animal studies have not been conducted, though available evidence suggest that administration of RhIG during pregnancy does not harm fetus[2]
- Lactation risk:
- Caution advised while breastfeeding, however no adverse events observed
- Renal Dosing
- No dosage adjustments
- Hepatic Dosing
- No dosage adjustments
Indications
- For risk of fetal maternal hemorrhage, such as blunt abdominal trauma
- Risk = >4-12wks
- Duration effect: 12wks
- Also given to Rh- male trauma patients who receive O+ blood to prevent future reaction with O+ transfusions[3]
Contraindications
- Allergy to class/drug
- Prior sensitization of mother
- Known Rh-negative father
- Known Rh-negative fetus (from cord blood)
Adverse Reactions
Serious
- Anaphylaxis
- Viral transmission risk
- Acute intravascular hemolysis in patients with ITP
- Acute transfusion reaction
Common
- Fever
- Injection site reaction
- Headache
- Myalgias
- Fatigue
Pharmacology
- Half-life: Approximately 30 days
- Metabolism: Unknown
- Excretion: Unknown
- Mechanism of Action:
- Exact mechanism unknown
- Prevents isoimmunization by suppressing immune response by Rh negative individuals against Rh positive blood cells
Comments
See Also
External Links
References
- ↑ RhD alloimmunization: Prevention in pregnant and postpartum patients. Uptodate. Accessed 2/4/21
- ↑ ACOG practice bulletin. Prevention of Rh D alloimmunization. Number 4, May 1999 (replaces educational bulletin Number 147, October 1990). Clinical management guidelines for obstetrician-gynecologists. American College of Obstetrics and Gynecology. Int J Gynaecol Obstet. 1999; 66(1):63-70. [PubMed 10458556]
- ↑ Miraflor, E, et al. Emergency uncrossmatched transfusion effect on blood type alloantibodies. J Trauma. 2012; 72:48-53.