Spontaneous Vaginal delivery- Rh Incompatibility

Spontaneous Vaginal delivery- Rh Incompatibility

Rh incompatibility occurs when an Rh-negative is exposed to the Rh-positive blood cells of her baby. This exposure usually occurs due to feto-maternal hemorrhage during the course of pregnancy or during normal delivery. Susan had a vertex delivery, and it is, therefore, possible that she could have been exposed to the baby’s blood cells. The possible consequence of this exposure would be sensitization to the rhesus antigen. The mother will produce IgG antibodies against the foreign rhesus antigen. Once produced, these antibodies persist for life. IgG antibodies can cross freely through the placenta into the fetal circulation. This will lead to the formation of antigen-antibody complexes in future pregnancies. The antigen-antibody complexes will initiate a cascade of events that will result in the destruction of fetal erythrocytes. This phenomenon is referred to as hemolytic disease of the fetus and newborn (HFDN) (Xie et al., 2020). Therefore, the second pregnancy with an Rh-positive baby will produce an anemic infant. The severity of this worsens with subsequent pregnancies. Succeeding pregnancies are at a much higher risk, and infants may even die in utero. To prevent the sensitization, an Rh IgG should be administered. Our assignment writing help is at affordable prices to students of all academic levels and academic disciplines.

Rhogam

Rhogam is a human anti-D immune globin. It suppresses the immune response of Rh-negative, non-sensitized mothers who have been potentially exposed to Rh-positive blood. This medication has a short half-life and acts fast to prevent Rh immunization. It should be administered to Rh-negative women at 28 weeks gestation or later as routine prenatal care. It should also be given within 72 hours post-delivery as routine postnatal care. The preferred route of administration is IM or IV. All Rh-negative women who have a termination of pregnancy in the first trimester should be given Rhogam. Once alloimmunization has occurred, Rhogam is not effective in preventing or reducing the severity of HFDN (Xie et al., 2020).

Rhogam should also be given to all Rh-negative women who have an increased risk of feto-maternal hemorrhage. Conditions that increase the risk of feto-maternal hemorrhage include abortions or miscarriages, trauma to the abdomen when pregnant, women who present with antepartum hemorrhage, women who have had procedures involving the use of instruments in the course of the pregnancy, or women who have delivered normally or using caesarian section (Kim et al., 2019).

References

Kim Y. S. (2019). Medical Concerns of Induced Abortion and Contraception. Journal of Korean Medical Science, 34(17), e137. https://doi.org/10.3346/jkms.2019.34.e137

Xie, X., Fu, Q., Bao, Z., Zhang, Y., & Zhou, D. (2020). Clinical value of different anti-D immunoglobulin strategies for preventing Rh hemolytic disease of the fetus and newborn: A network meta-analysis. PloS one, 15(3), e0230073. https://doi.org/10.1371/journal.pone.0230073

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Susan P. had an SVD (spontaneous vaginal delivery) today approximately 2 hours ago. The labor and delivery nurse is calling to give you a report. She is new, and I am not sure what you want to know from her.

Spontaneous Vaginal delivery- Rh Incompatibility

Question:

Note that you discover that Susan is Rh-negative; her baby is Rh-positive. What now?

Please discuss Rhogam. The drug, the need, the route, the risk.

When must you give this, and under what circumstances will you give this injection?

Please also recall any other reason Rhogam would be given and when.

Should have 2 reliable references, and every reference must have an in-text citation