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Re: RhogamFrom: Dean Huffman (dean@thehuffpeople.net)Fri Feb 27 01:10:26 2009
.. The only non-pregnancy complication I can think of is that if she becomes sensitized, then she would not be able to receive type specific, but RhD positive, blood in an ememrgency. (Yes, RhD positive blood can be given to RhD negative patients who are not alredy sensitized, but this is done only in an emergency and usually only for men. For example, in an emergency, a man could receive O Positive blood if there were not O Negative blood available. One benefit, I suppose, is that she could sell her serum to a company that makes RhD immune globulin. Downside: I cannot count the number of women who "will never have another pregnancy" who have had another pregnancy. Vasectomies fail. Patient gets new husband or boyfriend and he wants a baby. She gets raped and chooses not to terminate. Lots of things can happen. One option (but I have never seen a patient exercize this option) is to become pregnant by an RhD negative sperm donor. Another option, I suppose, if partner is heterozygous for RhD, is pre-implantation genetics. If she refuses, document, document, document. Get a consultant to talk to her. Have the nursing superviosr or head of the blood bank talk to her. Have her sign a statement that she is refusing RhoGam and has been told the risks. Bottome line, she will refuse, she will become sensitized, she will have another pregnancy, she will have complications, she will sue, she will win. - - - - FROM: Glen Elrod <dr99645@yahoo.com> Subject: Rhogam Date: Feb 26, 2009 2:17 PM Pt today is s/p delivery and is refusing Rhogam. Baby was Rh +, but they are certain they are done having kids. He is having a vasectomy. She states she will not have other children even if her children die, husband dies, etc. Is there any NON-pregnancy risk to not getting Rhogam now? Glen
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