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Re: Isoimmunization From: Luis Sanchez-Ramos, MD (luis.sanchez@jax.ufl.edu) Wed Mar 17 06:37:03 1999 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Matias Elena: "Visit any US OB-GYN DEPART in Miami" Previous message: dr. amit sengupta: "Re: Urgent" In reply to: natalie pierce, m.s.: "Isoimmunization" It seems to me that at the time of delivery you had a larger than usual fetal-maternal bleed (cesarean delivery?)and therefore probably only received a single dose of Rhogam (D immune globulin). A single dose of 300 mcg offers protection for as much as 15 ml of Rh positive red cells. Some patients, due to an excessive fetal-maternal (greater than 15 ml) transfusion require multiple doses. At some institutions(including ours) all pateitns who are candidates for D immune globulin administration get a fetal cell stain (to detect fetal maternal hemorrhage) in order to determine the amount of doses required. Others, only perform this screening test in cases at high risk for an excessive fetal-maternal bleed i.e, placenta previa, abruptio, cesarean section etc. How many out there perform a screening test (fetal cell stain) routinely, prior to Rhogam administration psot partum. By the way, Rh sensitization after receiving Rhogam at 28 weeks and at delivery is not that common ! It is in the range of 0.1%. -- Luis Sanchez-Ramos, M.D. At Wed, 10 Mar 1999, natalie pierce, m.s. wrote: > >Need suggestions with how to manage the following case. 37 yo wf >presented with c (1:32) and d (1:64) antigens s/p termination of 10 week >pregnancy due to no fetal heartbeat. G2 P1. Rhogam administered at 28 >weeks and postpartum. Non remarkable labs prior to miscarriage. Have >you ever seen a case where rhogam was given and still developed c and d >antibodies? What has been your experience with cases where next >pregnancy fetus has positive antibodies? Thanks. > >NTPIERCE@aug.com Next message: Matias Elena: "Visit any US OB-GYN DEPART in Miami" Previous message: dr. amit sengupta: "Re: Urgent" In reply to: natalie pierce, m.s.: "Isoimmunization"

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