Rh-Negative Pregnancy: Understanding RhoGAM and Antibody Levels

Question
Dear Brenda. I'm writing on behalf of my friend who is Rh-negative and is currently busy with her 14th week of pregnancy, this is her forth pregnancy, she has 2 children - 12 and 14 years old. 10 days ago she was informed that her blood titre analyses result is 1:2, and 3 days later the result was already 1:8. our question is: does it make sense for her and the baby to have Rhogam injection now? will it decrease the growth of antiboies concentration in mother's blood? if yes, then when and how many injections should she have? if Rhogam seems not to be effective, then what are the other treatment methods which help not to increase antibodies concentration? or what can be advised to ensure that future baby's organism doesn't suffer from mother's antibodies? unfortunately, the level of medical technologies in the country where we live is not quite satisfactory, so my friend's doctor prefers "wait and see" approach. but for us it's not acceptable, it's very important for my friend to have the third healthy child. thank you in advance for your help. with kindest regards, Regina

Answer
Dear Regina,

Sorry about the delay... I'm recovering from surgery.

Sensitization usually doesn't happen until after the birth of an Rh-positive baby. Therefore, in most cases Rh incompatibility is not a problem during a woman's first pregnancy and delivery of an Rh-positive baby. However, later pregnancies and deliveries may be affected unless the mother is treated with Rh-immune globulin (RhoGAM) after EVERY birth, miscarriage, and abortion.

Most often, the woman who is Rh-negative and carrying an Rh-positive baby will not begin producing antibodies until delivery when blood would potentially be mixed. However, the first dose of RhoGAM is typically given as an extra precaution around the 28th week of pregnancy. This can prevent rare cases where a woman would start producing Rh antibodies months before delivery. The way RhoGAM and sensitization works is complicated, but in a rather simplistic way, the injections tend to protect the pregnancy that follows AFTER.

I hope this has helped you and answered your question. I wish you well.

Brenda