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


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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?

 

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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.

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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.

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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. 

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