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IV vs IM Rho (D) Immune Globulin


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I don't know about all Rh Immune globulin preparations, but Rhophylac cannot be given IV for Antepartum prophylaxis.  It is cleared too quickly if given IV and doesn't protect the mom through to delivery.  For our postpartum patients, however, the IV administration is huge for patient satisfaction.

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3 hours ago, Joanne P. Scannell said:

We switched to Rhophylac here in the hospital because 'everyone' likes having the option of giving the dose IM or IV.

The MD's are still using RhoGam (no IV option) for their office injections (IM Only), e.g. Antenatal/Antepartum dose.

Ditto for us. It was actually nurse driven for patient satisfaction. The providers didn't care one way or the other except they weren't going to sign off on it if it cost more than RhoGAM. The only kicker is that the IVs are not discontinued as soon as they were when IM RhoGAM was administered. If the patient wants the IV out NOW, then they get the Rhophylac IM - their choice. We've had no issues.

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We give mostly IV RhIg post-partum.  I learned this because we started to get calls from nursing stating the Post Partum testing is STAT and where are the results.  If I have the specimen collected, I don't consider that testing STAT especially when I have other patients needing blood products.  Obviously, they want to give the RhIg so they can remove the patient's IV.  

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On 8/12/2020 at 11:16 AM, ksmith said:

We give mostly IV RhIg post-partum.  I learned this because we started to get calls from nursing stating the Post Partum testing is STAT and where are the results.  If I have the specimen collected, I don't consider that testing STAT especially when I have other patients needing blood products.  Obviously, they want to give the RhIg so they can remove the patient's IV.  

When we made the switch to Rhophylac, I made sure that there was a clear understanding that we would not be doing the workups STAT. They've been good about it. Once in a while they call and ask for a time estimate because a patient is getting anxious about the IV, but it's just for info, not pushing.

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