Don’t Be Afraid of the Rhogam Shot
The Rhogam Shot may sound scary, but I’m here to put your mind at ease.
People are often skeptical of things they don’t understand. The Rhogam shot and why it is highly recommended during and right after an Rh-negative person’s pregnancy is one of those things. Because I have Rh-negative blood, I have to get a shot during pregnancy and then possibly again once my baby is born? Ummm, no, keep your shots to yourself please and thank you. However, the protective effects of this shot are fairly important to not only understand but also to not be afraid of.
Red Blood Cell and Rh negative blood
All of the different cells in our body, red blood cells included, have various types of proteins on their surface that are responsible for different functions of the cell. Simply put, having Rh negative blood means that you are lacking a specific protein, the rhesus protein, on the surface of your red blood cells. Roughly 15% of the world’s population is born with Rh-negative blood. The role of our red blood cells is to carry oxygen to all of the tissues of our body. Without oxygen, tissues in our body rapidly decline and die. So red blood cells kind of have an important job to do.
Our immune system is complex…and amazing
Whenever our body is faced with some kind of foreign invader, our immune system will attack it in many different ways. Our immune cells, white blood cells, can punch holes in enemies, blast them, eat them, and even chew them to pieces. White blood cells perform these different functions depending on the type of white cell they are. These different types of cells are under two branches of white blood cells, called T-Cells and B-Cells. It is our B-Cells that are responsible for creating antibodies.
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An elephant never forgets….nor does an antibody
Our antibodies don’t actually kill foreign invaders. What they do instead, is attach themselves to surface proteins that are present on foreign cells. Once they attach themselves, they send out signals to white blood cells in the T-cell line to come over and perform their destructive tasks. What’s really cool about antibodies is that when they are made, some of them are also given a memory and are called memory B-cells, clever really. These memory cells are programmed to remember the protein that they were able to attach to on the foreign invader. If that enemy then returns, the memory cells are able to respond far quicker and stronger than the initial invasion.
The good news in all this is that not only are we protected pretty well against foreign invaders, but also that these antibodies leave our own cells alone (most of the time).
What does this have to do with pregnancy?
A baby in utero of an Rh-negative parent can still receive the Rh gene from the other parent if that parent is Rh positive. A person only needs to receive one Rh gene in order to be Rh positive. Exposure of the baby’s blood to an Rh-negative parent’s bloodstream can trigger an immune response by the parent. This is because the immune system will view the presence of that Rh protein as a foreign invader.
So what happens if exposure occurs?
While exposure to the baby’s blood is actually a rare event, exposures generally occur due to miscarriage, abortion, abnormal bleeding, ectopic pregnancy, chorionic villus sampling, amniocentesis or abdominal trauma. If exposure does occur, the immune response can include the creation of memory antibodies to the Rh protein, which is something called sensitization of the parent. The creation of memory antibodies will not harm the current pregnancy. However, remember that subsequent exposure of an invader will elicit a faster and stronger immune response? So if a parent has a second pregnancy with an Rh-positive baby, should exposure occur again (also rare), the parent’s immune system will enact an assault on the baby’s red blood cells. And because these antibodies can cross the placenta, dangerous levels of hemolytic anemia can occur in the baby.
A note about hemolytic anemia
The premature destruction of red blood cells is called hemolytic anemia. As more and more red blood cells are destroyed, less and less oxygen is able to get to all of the tissues in the body. Additionally, red blood cells contain bilirubin. When red blood cells live out their lives, normal biochemical processes will repurpose the bilirubin. However, when red blood cells are destroyed by an immune response, the body is often unable to keep up with the amount of bilirubin. High levels of bilirubin lead to reversible neonatal jaundice but can also cause irreversible brain damage. Coupled with dangerous levels of hemolytic anemia and the baby’s life will be in danger. Cases can range from mild to moderate, which can be anything from mild anemia to more severe cases requiring an intrauterine blood transfusion. Severe cases can lead to stillbirth.
The amazing job of Rhogam
In order to prevent Rh negative parents from becoming sensitized to the Rh protein, researchers focused on creating an injectable liquid with the ability to bind to the Rh protein of any fetal red blood cells that may have entered the parent’s bloodstream. This binding, called neutralization, prevents the parent’s immune system from viewing and reacting to the baby’s red blood cells, essentially preventing the system from creating antibodies against the red blood cells.
Don’t fear the Rhogam Shot!
The likelihood of an Rh-negative person reproducing with an Rh-positive person is high. The Rhogam shot is there to help prevent any dangers to a baby in utero and it does its job very well. An added bonus for us vegans: it is made entirely from human proteins!
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