Rhogam After Abortion: Understanding Your Post-Procedure Needs

Question
I am turning 27 next week. The begining of this year 2005 i found out i was pregnant unexpectedly, me and my husband thought about where we were at the times in our life and made the decision to abort.  I was unaware at the time what my blood type was, went to a clinic and had a procedure done.  Four months later, i was pregnant again. This time we decided to keep the baby. My regular obgyn tested my blood type to find out i was A negative. The nurse informed me that i would have to recieve the shot of rhogam at 28 weeks and once i deliever.   Three days ago 19 weeks and 6 days into my pregnacy i started to bleed and we lost the baby. The doctor told me it was something called placenta abration and the ultrasound tech told us it was a gap in the amointic sac and the baby was trying to abort itself.  Could this of happened becuase i did not recieve the shot after the abortion?  I am almost certain that they did not inform me, i have requested my medical records from the clinic to see if they had administred me a shot.  If they didnt, could of this been a cause of my miscarriage?
Any advice would be greatly appreciated, we feel very lost and confused.  

Answer
When a woman has Rh Negative blood, it means that she does not have the Rh factor in her blood. This is not a problem unless she is pregnant. If her husband has Rh Positive blood (with the Rh factor) the baby may have Rh positive blood type. If that was your first pregnancy there is no problem. However, after the pregnancy, you can build up antibodies to Rh Positive blood and when you are pregnant again, these antibodies can cross the placenta and cause erythroblastosis fatalis (blue baby syndrome). For this reason, we give a shot of RhoGam (Rh immune globulin) whenever you miscarry or while you are pregnant (at 28 weeks and just after delivery). By giving the RhoGam, you do not produce antibodies on your own. However, this was not the reason you miscarried. YOu had a placental abruption, which is a premature separation of the placenta which causes you to lose the baby. It had nothing to do with you not receiving the RhoGam shot. You can easily get a blood test now which will tell you if you are sensitized or not (from Rh Positive antibodies). Next pregnancy, you will need RhoGam shot at 28 weeks.