Natural Birth and Baby Care.com

Rhogam and Complete Previa?

by Georgia
(Chicago, IL, USA)

Hi, Kristen.

I am at 29 weeks in my pregnancy, and I have Complete Placenta Previa... which as you may know, is a condition that could quite possibly cause bleeding in my uterus at some point in my third trimester.

My doctors have told me to get a Rhogam shot {which is scheduled for tomorrow}, and I just came across your article about the dangers of arbitrary Rhogam shots like this. I have not yet begun to bleed, nor do I know that I will for sure. But since there is a high likelihood of it, I am not sure if getting the shot outweighs the risks of not having the shot.

Your article concerned me a great deal, and though it is all new terminology, I understand it all. I just don't know what is a greater risk at this point... the shot, or the chance of my Rh- blood mixing with my child's in this last trimester. {My husband's blood is Rh+, so I know there is a possibility of the baby's blood being Rh+ as well.}

Your article did not mention anything pertaining specifically to the case of previa bleeding, but I assume that any bleeding from previa would fall under the term "trauma" that you use in the article.

Do you have any helpful advice for me? I am so concerned now... and I am rethinking having this shot given tomorrow.

~Georgia

Answer:

Georgia also emailed me, and here is the follow-up response I sent to her:

I am so sorry for the situation you are in! It is always hard to weigh the pros and cons in situations where there are complications.

In your case I feel that the benefits of the Rhogam would far outweigh the risks - though Rhogam is a blood product and usually there is *not* any mixing of blood during pregnancy, with a previa there is a great chance of bleeding and possible mixing of the blood. The possible side effects of Rhogam are minor compared to what any future babies would have to go through should you become sensitized during this pregnancy. Unless this is absolutely your last pregnancy I would feel completely comfortable getting the shot - and also get it postpartum unless your baby's blood type is also Rh-.


Sometimes we do make choices that we would rather not make for the safety of our babies. I always recommend that a woman carefully consider any kind of intervention, but there are times we want to take the option. I recently had a virus and my temperature kept creeping upwards. Normally I never take any medication during pregnancy, and never for a fever because I believe they are serving a purpose during illness - but while pregnant I did not want to be running a fever over 100 degrees. I was grateful that Tylenol was an option that brought it down quickly. Sometimes we use interventions/medications that we would otherwise choose not to have - and I think it's important to feel comfortable with that and *not* feel guilty.

I have had Rhogam postpartum after three of my babies (I have had three Rh+ babies, one Rh-, and the baby I am pregnant with now is Rh-) and had no complications from the shot - I prefer to skip the prenatal dose, but I would comfortably get it in a situation like yours.