- Aligned with ACOG/AABB Standards
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Aligned with ACOG/AABB Standards

MATCHING THE STANDARD, SETTING THE STANDARD

The American College of Obstetricians and Gynecologists (ACOG) provide guidelines for the administration of Rho(D) immune globulin products.10 These standards were set to ensure that Rh-negative mothers receive appropriate anti-D titers through term when administered properly. That RhoGAM® Brand dosing guidelines are aligned with ACOG standards is no surprise—ACOG standards were based on the pharmacokinetics of RhoGAM® Brand.10,11


CLEARLY DEFINED DOSING INFORMATION HELPS MAXIMIZE PROTECTION

ACOG standards and the AABB both recommend the first dose of Rho(D) immune globulin to be given at 28 weeks’ gestation9,10 (earlier if there’s been an invasive event), followed by a postpartum dose given within 72 hours of delivery.9,10 Because the dosing frequency of RhoGAM® Brand is 12 weeks, patients given the dose at 28 weeks are covered through a normal 40-week pregnancy. This is an important distinction because the half-lives of some Rho(D) immune globulin products may be shorter and may require a second prenatal dose to ensure titer coverage to term. Also, if delivery does not occur at week 40, an additional dose of RhoGAM® Brand should be administered.

“To maintain protection through a pregnancy, an adequate level of anti-D must be maintained. The half-life of IgG is 23 to 26 days. If RhIG has been given before 28 weeks’ gestation, it is advisable to repeat the dose every 12 weeks to ensure adequate levels until delivery.” 9
–AABB

References:

  1. RhoGAM® Ultra-Filtered PLUS Package Insert. Ortho Clinical Diagnostics.
  2. RhoGAM® Ultra-Filtered Marketing Authorization Application: Part IB1. Summary of Product Characteristics. Ortho Clinical Diagnostics. November 2000.
  3. Pollack W, Ascari WQ, Kochesky RJ, et al. Studies on Rh prophylaxis. 1. Relationship between doses of anti-Rh and size of antigenic stimulus. Transfusion. 1971;11:333-339.
  4. Frigolette FD Jr, ed. Antepartum administration of Rh immune globulin: a guide to office procedure. Raritan, NJ: Ortho-Diagnostic Systems, Inc. 1983.
  5. Bowman JM, Chown B, Lewis M, et al. Rh isoimmunization during pregnancy: antenatal prophylaxis. Can Med Assoc J. 1978;118:623-627.
  6. Bowman JM, Pollock JM. Antenatal prophylaxis of Rh isoimmunization: 28-weeks’ gestation service program. Can Med Assoc J. 1978;118:627-630.
  7. Baskett TF, Parsons ML. Prevention of Rh(D) alloimmunization: a cost-benefit analysis. Can Med Assoc J. 1990;142;337-339.
  8. Bowman JM. Antenatal suppression of Rh alloimmunization. Clin Obstet Gynecol. 1991;34:296-303.
  9. Mintz PD. Rh Immune Globulin. In: Mintz PD, ed. Transfusion Therapy: Clinical Principles and Practice, 2nd Edition. Bethesda, MD: AABB Press; 2005.
  10. Freda VJ, Gorman JG, Pollack W, et al. Prevention of Rh hemolytic disease—ten years’ clinical experience with Rh immune globulin. N Engl J Med. 1975;292:1014-1016.
  11. Prevention of Rh D Alloimmunization. ACOG Practice Bulletin. Number 4, May 1999. Clinical management guidelines for obstetrician-gynecologists. American College of Obstetricians and Gynecologists.