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Rh immunization: don't get lulled into complacency. (Maintain Vigilence).
CANCUN, MEXICO -- The decrease in lost fetuses because of Rh immunization is one of the major triumphs of modern obstetrics, but because cases are now uncommon, the few that do occur can slip through the cracks more easily.
All Rh-negative women who are pregnant must have their Rh immunization status checked, they must receive prophylaxis if immunization is a threat, and when an immunized woman is carrying a fetus that's at risk the fetus must be regularly monitored and treated with cordocentesis when needed, Dr. John T. Queenan said at a conference on obstetrics, gynecology perinatal medicine, neonatology, and the law.
"Prevention is imperfect," said Dr. Queenan, professor of ob.gyn. at Georgetown University in Washington. "Usually in medicine, we immunize people to boost their antibody levels, but in women who are Rh negative we try to coat the Rh antigen with antibody to make it invisible to the mother's immune system. Inevitably this strategy sometimes fails, and Rh immunization occurs.
Without immunization, about 13% of Rh-negative women who carry an Rh-positive fetus will become immunized. With a two-step immunization protocol, using [Rh.sub.o] (D) immune globulin (RhoGAM) administered at 28 weeks' gestation and within 3 days post partum, the risk drops to about 0.16%. Rh immunization should also be used for all spontaneous abortions that occur at or beyond 8 weeks' gestation and any time an Rh-negative woman receives a mismatched transfusion.
Rh immunization is vital even for a woman who is ...
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Source: HighBeam Research, Rh immunization: don't get lulled into complacency. (Maintain...