Jump to content
Sign in to follow this  
studenttttttt

Is there a concern on Rh-NEG pregnant woman with BMI > 28 and their absorption of RhIG (intramuscular)?

Recommended Posts

Quote

there is concern on Rh negative pregnant women over 28 BMI  and absorption of RhIG by intramuscular administration. The Woefler study in Transfusion 2007 showed a dramatic drop in absorption after 3 days in these women. And as we know it takes up to 7 days for a preventive titer to be a bsorbed, this could put them at risk of sensitization. 

I saw the above comment from a post several years ago.

Does anyone know more about this? Is this an actual concern being taken up by hospitals?

 

Share this post


Link to post
Share on other sites

One of my colleagues, Dr Fiona Regan, was a co-author of a poster at a BBTS Annual Scientific Meeting at, I believe, Bournemouth a few years ago, which looked at this (and won one of the prizes).  They did show that it made a difference, BUT, I don't think anyone ever took any notice of it, because, as far as I know, nobody ever gives extra anti-D to the larger woman.

Share this post


Link to post
Share on other sites

Nurses are supposed to know how to give intramuscular injections to heavier patients.  That said, it can be given intravenously or sub-cutaneously with equal benefit, although few outpatient practices give intravenous injections.  With very heavy patients, a longer needle works.

Share this post


Link to post
Share on other sites

Worth noting not all preparations can be given IV, it depends on the filtration methods used. One of the main suppliers in the UK (BPL) could only be used IM, Rhophylac by CSL Behring can be administered IV. 

Share this post


Link to post
Share on other sites
2 hours ago, srichar3 said:

Worth noting not all preparations can be given IV, it depends on the filtration methods used. One of the main suppliers in the UK (BPL) could only be used IM, Rhophylac by CSL Behring can be administered IV. 

Actually, they did also make an IV product, with an enormous amount of anti-D in terms of International Units, but they made very little, and it was kept almost exclusively at NHSBT Centres for use when a unit of D Positive blood has been transfused to a D Negative individual either by mistake, or to save their life.  I agree though, the IM anti-D immunoglobulin should only ever be given IM.

Share this post


Link to post
Share on other sites
24 minutes ago, Malcolm Needs said:

Actually, they did also make an IV product, with an enormous amount of anti-D in terms of International Units, but they made very little, and it was kept almost exclusively at NHSBT Centres for use when a unit of D Positive blood has been transfused to a D Negative individual either by mistake, or to save their life.  I agree though, the IM anti-D immunoglobulin should only ever be given IM.

Are BPL still going? I gave up on them in the end, so many supply issues over the years, the only real advantage of BPL over the other suppliers was the fact they did a 250iu then they stopped producing that to concentrate on the 500 and 1500's. Plus the fact it was a lot cheaper than the CSL product. 

Share this post


Link to post
Share on other sites

Create an account or sign in to comment

You need to be a member in order to leave a comment

Create an account

Sign up for a new account in our community. It's easy!

Register a new account

Sign in

Already have an account? Sign in here.

Sign In Now
Sign in to follow this  

  • Advertisement

×
×
  • Create New...

Important Information

We have placed cookies on your device to help make this website better. You can adjust your cookie settings, otherwise we'll assume you're okay to continue.