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RhoGAM

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1. RhoGAM

RhoGAM RhoGAM Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 RhoGAM RhoGAM Aka: RhoGAM , RHO Immune globulin II. Indications (...) Prevention of in Rh negative mother III. Timing Uterine bleeding or Routine scheduled dosing for Rh negative mother : 28 weeks Postpartum IV. Dose Uterine bleeding RhoGAM dose based on Give 300 ug per 30 ml fetal whole blood or 15 ml No Uterine bleeding Gestation under 13 weeks: RhoGAM 50 ug IM Gestation over 13 weeks: RhoGAM 300 ug IM Images: Related links to external sites (from Bing) These images are a random sampling from a Bing search on the term "RhoGAM." Click on the image (or right click) to open

2018 FP Notebook

2. RhoGAM

RhoGAM RhoGAM Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 RhoGAM RhoGAM Aka: RhoGAM , RHO Immune globulin II. Indications (...) Prevention of in Rh negative mother III. Timing Uterine bleeding or Routine scheduled dosing for Rh negative mother : 28 weeks Postpartum IV. Dose Uterine bleeding RhoGAM dose based on Give 300 ug per 30 ml fetal whole blood or 15 ml No Uterine bleeding Gestation under 13 weeks: RhoGAM 50 ug IM Gestation over 13 weeks: RhoGAM 300 ug IM Images: Related links to external sites (from Bing) These images are a random sampling from a Bing search on the term "RhoGAM." Click on the image (or right click) to open

2015 FP Notebook

3. RhoGam--current status. (PubMed)

RhoGam--current status. 4098761 1971 02 02 2018 11 13 0008-1264 113 6 1970 Dec California medicine Calif Med RhoGam--current status. 44-5 Russell K P KP eng Journal Article United States Calif Med 0410260 0008-1264 0 Immunoglobulins 0 Rh-Hr Blood-Group System 0 gamma-Globulins IM Abortion, Therapeutic Erythroblastosis, Fetal prevention & control Female Humans Immunoglobulins Infant, Newborn Pregnancy Rh-Hr Blood-Group System gamma-Globulins administration & dosage 1970 12 1 1970 12 1 0 1 1970

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1970 California Medicine

4. The multiple use of RhoGAM. (PubMed)

The multiple use of RhoGAM. 4631466 1973 04 11 2018 11 13 0027-9684 65 1 1973 Jan Journal of the National Medical Association J Natl Med Assoc The multiple use of RhoGAM. 40-4 Keith L L Halloway M M Stepto R C RC eng Journal Article United States J Natl Med Assoc 7503090 0027-9684 0 Isoantibodies 0 Rh-Hr Blood-Group System IM Antibody Formation Blood Group Incompatibility therapy Blood Transfusion Erythroblastosis, Fetal immunology prevention & control Female Humans Immunosuppression

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1973 Journal of the National Medical Association

5. Prevention of Rh Alloimmunization

, anti-Rh, WinRho, Rhogam, and pregnancy. Additional publications were identified from the bibliographies of these articles. All study types were reviewed. Randomized controlled trials were considered evidence of highest quality, followed by cohort studies. Key individual studies on which the principal recommendations are based are referenced. Supporting data for each recommendation is briefly summarized with evaluative comments and referenced. Values The evidence collected was reviewed

2018 Society of Obstetricians and Gynaecologists of Canada

6. CRACKCast E177 – Acute Complications of Pregnancy

tenderness ● Abdominal pain (concealed hemorrhage) ● Uterine contractions Late/severe signs: ● Fetal distress ● Shock ● DIC What is the management bleeding in late pregnancy? If unstable – resuscitate as hemorrhagic shock and give Rhogam Initiate continuous fetal monitoring Follow coagulation studies and resuscitate accordingly – platelets, PT, PTT, fibrinogen *Any women with painless second trimester bleeding should be assumed to have placenta previa till proven otherwise – DO NOT probe the cervix (...) fluid resuscitation, Inotropic cardiovascular support, Anticipation and management of consumptive coagulopathy. 17) In whom is RhoGam indicated? What is the dose? Rh immunization occurs when an Rh-negative woman is exposed to Rh-positive fetal blood. To prevent this, anti-D immune globulin (RhoGAM) is routinely administered to Any Rh- woman with: Risk for spontaneous sensitization At 28 weeks gestation in an Rh- woman with a father who is Rh+ or unknown At risk for transplacental hemorrhage: uterine

2018 CandiEM

7. Gwyneth Paltrow and Goop double down on quackery by featuring an HIV/AIDS denialist and antivaccine quack at its upcoming Goop Summit

for newborns, RhoGAM, antibiotics, GMOs, bras, plastic containers, cell phones, wifi, Tylenol, prenatal ultrasounds, Lyme disease, psychiatric medications, noise pollution, vitamin D supplementation, folate supplementation for pregnant women, toxins in cookware, plastics, cleaning supplies, cosmetics, an unhealthy microbiome, sugar, gluten, C-sections, baby formula, deodorant, and so much more! They will also ban all dissent. Because they are “Fearless.” epsilon413 Maybe next month they’ll be trying

2017 Respectful Insolence

8. Study on the Safety and Immunogenicity of Boostrix Vaccine in Pregnant Malian Women and Their Infants

within 30 days before or after vaccination or any inactivated licensed vaccine within 14 days before or after vaccination. Receipt of immunoglobulin (except RhoGAM, which is allowed) or other blood products within 90 days prior to study vaccination. Receipt of an experimental agent or device within 30 days prior to vaccination, or the expected receipt of an experimental agent* (other than BOOSTRIX) during this trial-reporting period. *Experimental agents include vaccines, drugs, biologics, devices

2018 Clinical Trials

9. 21 years later, a physician reflects on the changes in medicine

, she received RhoGAM at the beginning of her third trimester to avoid forming antibodies to her baby if her baby was RH positive (something we wouldn’t know until the time of delivery). But, on that day 21 years ago, something seemed different to her. She sensed her baby wasn’t moving like usual and came to the office. I put a fetal heart rate monitor on her belly to perform a nonstress test and watched for 30 minutes. On first blush, the baby’s heart rate looked “OK” — the baby’s heart rate showed (...) that was limp and floppy. The baby was handed to the neonatologist in the room and resuscitated. The baby ultimately needed a blood transfusion before she finally stabilized. The remainder of the C-section went smoothly, but the danger for my patient was not over. The blood in the amniotic fluid indicated there had been a large bleed between her and her baby — nearly costing the baby her life. It also meant my patient was exposed to a large amount of her daughter’s blood — she would need extra RhoGAM so

2018 KevinMD blog

10. What does trust mean to a patient?

it likely that she would form antibodies to the baby in her belly and in every subsequent pregnancy. Women with her blood type need an injection called Rhogam to prevent harm or even death to their baby but she refused the Rhogam shot. She was not only risking herself and her baby, she was risking any future baby’s life. The morning I met her, I knew I had to leave my preconceived ideas of her at the door and remain open minded, or nothing would be gained. I admit it wasn’t easy knowing the potential (...) , this is not what I wanted.” I tried to engage her more, trying to understand why she wouldn’t accept medication to prevent seizures and why she wouldn’t accept Rhogam. “I don’t want anything foreign in my body“ was all she said and then wouldn’t add anything more. She had had her fill of doctors and nurses and was adamant nothing was going to convince her to change her mind. Her husband then piped in abruptly, “Why can’t she labor in a tub like she wants?” He definitely didn’t grasp the gravity

2017 KevinMD blog

11. A physician was the victim of malpractice. Here’s her story.

of the long: My obstetrician messed up. She took care of my pregnancy during one of the most difficult periods of my life, medical residency. She missed a shot that should have been given. RhoGam, to be exact. What Is RhoGam? RhoGam is an injection. The baby forming inside of my belly was Rh-positive, surrounded by my Rh-negative blood. The purpose of administering the injection would be to basically confuse my body into not “noticing” this inconsistency and move forward normally, without a hitch. Except (...) reacted in a rare way and that this could have been prevented, but to also have my honesty questioned. They were hoping it was a mistake, that I was an anomaly, and scampering to find an alternate cause, other than physician negligence. In hindsight — which, in medicine, is always 20-20 — and in speaking with many obstetricians since, it turns out RhoGam is considered an automatic knee-jerk injection to those in the field. It rarely gets missed in this day and age. But it was! I was missed! Please

2017 KevinMD blog

12. Medical treatment of ectopic pregnancy: a committee opinion

pregnancy>4 cm in size as imaged by transvaginal ultrasonography Refusal to accept blood transfusion Inability to participate in follow-up Note: MTX¼ methotrexate. Practice Committee. Medical treatment of ectopic pregnancy. Fertil Steril 2013. TABLE 2 Multiple-dose MTX treatment protocol (28, 29). Treatment day Laboratory evaluation Intervention Pretreatment hCG, CBC with differential, liver function tests, creatinine, blood type, and antibody screen Rule out spontaneous abortion RhoGAM if Rh negative (...) abortion Rhogam if Rh negative 1 hCG MTX 50 mg/m 2 IM 4 hCG 7 hCG MTX 50 mg/m 2 IM if b-hCG decreased 4 cm) High initial hCG concentration (>5,000 mIU/mL) Presence of free peritoneal blood Rapidly increasing hCG concentrations (>50%/48 h) before MTX Continued rapid rise in hCG concentrations during MTX Note: MTX¼ methotrexate. Practice Committee. Medical treatment of ectopic pregnancy. Fertil Steril 2013. VOL. 100 NO. 3 / SEPTEMBER 2013 641 Fertility and Sterility®ADJUNCTIVEUSEOFMTX A persistent

2013 Society for Assisted Reproductive Technology

13. Safety and Immunogenicity of Simultaneous Tdap and IIV in Pregnant Women

months. 4. Has an active neoplastic disease (excluding non-melanoma skin cancer), a history of any hematologic malignancy, current bleeding disorder, or taking anticoagulants (daily low dose aspirin may be acceptable). 5. Has a history of receiving immunoglobulin or other blood product (with exception of Rhogam) within the 3 months prior to enrollment in this study. 6. Known to have pre-existing diabetes mellitus or an autoimmune disorder. 7. Febrile illness within the last 24 hours or an oral

2016 Clinical Trials

14. Rh Sensitization

Sensitization , Rh Isoimmunization From Related Chapters II. Pathophysiology Maternal Formation to fetal Rh IgM (Agglutinates in ) forms in 7 days Does not cross placenta IgG (Agglutinates in Albumin) forms in 21 days Crosses placenta easily Results in Neonatal III. Indications for giving RhoGAM (xD) to Rh Negative Mother Standard Timing Week 28 gestation Postpartum (under 3 days postpartum if baby Rh+) Additional Indications Placenta Separation Labor Third Stage Termination or after 6 weeks Antepartum

2018 FP Notebook

15. “CDC whistleblower” William Thompson appears to have turned antivaccine

contains the health records of some 1200 children, 800 of which are confirmed autistic, with complete vaccination records, including prenatal vaccines and RhoGAM shots. This data has yet to be released to the public for study. In fact, according to Dr. Thompson, “it is under lock and key.” However, as Dr. Thompson says, “So far there is about sixty proposals in, um, for people ready to do studies. Not a single one of them looks at vaccines, not one!” He is clearly outraged by this when he recounts how

2015 Respectful Insolence

16. Inhibition of Phagocytic Recognition of Anti-D Opsonized Rh D+ RBC By Polymer-Mediated Immunocamouflage. (PubMed)

. The immunocamouflage of D was polymer size and grafting concentration dependent as determined using human anti-D alloantibodies (both pooled [RhoGAM] and single donors). Importantly, the 20 kDa polymer provided excellent immunocamouflage of D and reached a clinically significant level of protection, as measured by the MMA, at grafting concentrations of ≥1.5 mM. These findings further support the potential use of immunocamouflaged RBC to reduce the risk of acute transfusion reactions following administration of D

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2015 American journal of hematology

17. Vaccine Responses in Infants After Acellular Pertussis Vaccination During Pregnancy in Thailand

Significant mental illness History of febrile illness (greater than or equal to 38°C) within the past 72 hours before injection Previous severe reaction to any vaccine Receipt of tetanus-diphtheria toxoid immunization within the past 1 month Receipt of an pertussis containing vaccine (Tdap) in the last 5 years Receipt of a vaccine, blood product (excluding Rhogam) within the 4 weeks prior to injection through 4 weeks following injection and IVIG (Intravenous Immunoglobulins) within 12 weeks period. One

2015 Clinical Trials

18. Maternal Tdap Immunization in Guatemala

within the preceding 3 month (with the exception of Rhogam), History of allergy to any component of the vaccines (i.e. eggs, egg proteins, gelatin, formaldehyde, glutaraldehyde, polyethylene glycol p-isooctylphenyl ether, sucrose, aluminum hydroxide, polysorbate 80) or to latex, History of severe reaction (including hypersensitivity) after receiving any vaccine, History or evidence of immunosuppression (due to illness or treatment) or is on immunosuppressive therapy (includes long term use

2014 Clinical Trials

19. Erythrocyte Alloimmunization and Pregnancy (Overview)

decreased dramatically since the institution of routine anti-D immune globulin (RhoGAM) prophylaxis for Rh-negative women in the 1960s. A review of birth certificate data in 2003 reported the incidence of Rh sensitization to be approximately 6.8 per 1000 live births. [ ] The Rh system was discovered in 1940 when Landsteiner and Weiner performed their landmark experiments wherein rhesus monkey erythrocytes were injected into rabbits and guinea pigs. The resultant antisera were mixed with blood samples (...) that the passage of fetal Rh D–positive erythrocytes into the maternal circulation caused Rh immunization. In 1960, the administration of Rh D IgG, also known as anti-D immune globulin, or RhoGAM, was demonstrated to prevent Rh D alloimmunization, leading to the licensing of anti-D IgG in 1968 for use in North America. Anti-D IgG administration has been enormously successful in preventing maternal alloimmunization . Previous Next: Pathophysiology Fetomaternal hemorrhages have been demonstrated to occur

2014 eMedicine.com

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