Re: Antenatal Rhogham

From: zygote@icsi.net
Fri Mar 24 18:21:32 2006


The concept is referred to as immunological enhancement and has been stated for many years. Small volumes of Ab bind with hapten and instead of destruction and removeal from circulation are processed with primary immune response as result with formation of endogenous Rh ab.

It is better to have excess antibody that two little ab. As someone who has published and does IUT's for really sick alloimunization with severe anemia - no fun! Prevention is better.

Hope this helps - reference exists but have not loked for it for years!

Bob

On 24 Mar 2006 at 18:39, Dean Huffman . wrote:

Date sent: Fri, 24 Mar 2006 18:39:48 -0600 Send reply to: ob-gyn-l@obgyn.net From: "Dean Huffman ." <dean@thehuffpeople.net> To: Multiple recipients of list OB-GYN-L <ob-gyn-l@dns.obgyn.net> Subject: Re: Antenatal Rhogham

> .
>
> I seem to have heard at one time, although I could never find a printed
> reference, that the time of greatest risk for sensitization is when the IgG
> titers from RhoGam are extrememly low, but not yet absent. Has anybody else
> ever heard this? If so, do you have a reverence?
>
> - - - -
>
> Date: Fri, 24 Mar 2006 10:29:56 -0600
> From: doctorjoe@aol.com
> Subject: Re: Antenatal Rhogham
>
> Interesting problem and one cannot be unsympathetic.
>
> Still, the risk of sensitization with this pregnancy, and then with possible
> effects on subsequent gestations, fairly mandates some action.
>
> The least expensive course might be to obtain the indirect Coombs first and
> detect any residual antibodies, which, if present, would indicate ongoing
> levels of RhoGam "protection". This would obviate the need for redosing before
> delivery, which would at least save the cost of the RhoGam now.
>
> On the other hand, if the screen is negative, then she needs another dose.
> Right?
>
> Joe P.
>
> -----Original Message-----
> From: igold@cox.net
> To: Multiple recipients of list OB-GYN-L <ob-gyn-l@dns.obgyn.net>
> Sent: Fri, 24 Mar 2006 10:19:01 -0600
> Subject: Antenatal Rhogham
>
> I saw a patient today who received her Rhogham a bit early, at 25 4/7 weeks. She
> is 37 weeks now. Would anyone recommend repeating her rhogham since it has
been > 12 weeks and she is unlikely to deliver imminently? Thanks, Ingrid Gold,CNM PS
> She is uninsured and poor (and undocumented so ineligible for prenatal
> entitlement services), so would have to pay out of pocket for the bloodwork and
> Rhogham.
>

Robert J. Carpenter, Jr. MD 6624 Fannin, #2720 Houston, TX 77030 (O) 713-795-4600 (F) 713-795-4422

"Life is difficult" The Road Less Travelled by Scott Peck





use when must restrict search to only the ob-gyn-l forum...
Enter search keywords:
Returns per screen: Require all keywords:

Return to  OB-GYN-L Mail a New Message to the Forum: ob-gyn-l@obgyn.net
Forum Administrator: geffrey.klein@obgyn.net
Report Technical Problems: webmaster@obgyn.net
Last Updated: Wed Jul 2 04:43:13 2008

The American Medical Association is no longer designating CME hours for AMA Category II CME credit. However, physicians themselves may self designate learning activities as Category II CME credit hours if they feel it is of sufficient educational merit and meets the formal definitions of continuing medical education. OBGYN.net believes these interaction in this forum meets these criteria. For further information see the AMA web site.