Contributing Factors to consider:
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Medication:
Rh(D) Immunoglobulin-VF
Route & Typical Dose:
IM
Human anti-D (RhO) Ig (human plasma protein ≥ 10 mg/mL (250 IU vial) or ≥ 30 mg/mL (625 IU vial) containing Ig (mainly IgG) ≥ 98%); glycine; preservative free; vial
Warm to room temperature before use. Admin by slow deep IMI; max 5 mL/site. Sensitising events in pregnancy. Admin ≤ 72 hrs after event. 1st trimester: 250 IU. > 1st trimester (incl suspected), multiple pregnancies, fetomaternal haemorrhage ≤ 6 mL: 625 IU. Fetomaternal haemorrhage > 6 mL, Rh(D) +ve blood transfusion: 100 IU/mL Rh(D) +ve RBCs. Complex, see full PI
Human anti-D (RhO) Ig (human plasma protein ≥ 10 mg/mL (250 IU vial) or ≥ 30 mg/mL (625 IU vial) containing Ig (mainly IgG) ≥ 98%); glycine; preservative free; vial
Warm to room temperature before use. Admin by slow deep IMI; max 5 mL/site. Sensitising events in pregnancy. Admin ≤ 72 hrs after event. 1st trimester: 250 IU. > 1st trimester (incl suspected), multiple pregnancies, fetomaternal haemorrhage ≤ 6 mL: 625 IU. Fetomaternal haemorrhage > 6 mL, Rh(D) +ve blood transfusion: 100 IU/mL Rh(D) +ve RBCs. Complex, see full PI
indication:
Maternal Negative Blood Group with no previous sensitisation
Anti-Rh(D) Ig. Prevention of Rh sensitisation in Rh(D) -ve females at or below childbearing age
Anti-Rh(D) Ig. Prevention of Rh sensitisation in Rh(D) -ve females at or below childbearing age
Mode of Action:
IM
Presentation:
Negative blood group with no previous sensitisation
Management/administration considerations:
Offer at 28/40 & 34/40 or within 72hrs of a sensitising event. (Amnio. CVS, trauma, medical birth, abortion, miscarriage.
Not for IV admin; BMI ≥ 30; prior systemic allergy to human Ig; poss disease transmission eg CJD (consider vaccination where appropriate); elderly; pregnancy, lactation, children
Interactions: Live vaccines eg poliomyelitis, measles (≤ 2 wks before, 3 mths after dose); Ab (eg Coombs' test), serological tests; blood typing; do not admix (excl hyaluronidase, suitable local anaesthetics)
Not for IV admin; BMI ≥ 30; prior systemic allergy to human Ig; poss disease transmission eg CJD (consider vaccination where appropriate); elderly; pregnancy, lactation, children
Interactions: Live vaccines eg poliomyelitis, measles (≤ 2 wks before, 3 mths after dose); Ab (eg Coombs' test), serological tests; blood typing; do not admix (excl hyaluronidase, suitable local anaesthetics)
Side effect:
Inj site reaction; pyrexia; urticaria; malaise; drowsiness; hypersensitivity, convulsion (rare); others, see full PI
Contraindications:
Rh(D) +ve (incl postpartum infants), Du +ve patients; Rh(D) -ve, Du -ve patients previously sensitised to Rh(D) Ag; isolated IgA deficiency (unless no circulating anti-IgA Abs); severe thrombocytopenia, coagulation disorder contraindicating IMI