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    Rhogam Shot mix-up
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    Jessica22738 posted:
    Well as I was leaving my Dr's appt I asked the Dr if next appt I would get my Rhogam Shot in addition to taking my glucose test and he said yes. Well as I'm heading out the door he runs and grabs me and tells me I'm not RH+ but rather B+, so I don't need the shot. I explain to him that when I was preggo with my DD they told me I was RH+ and needed the shot and got it at 27w and again after I delivered her. Then the tested my DD's blood to make sure she didn't have the RH factor b/c if she did, she would need the shot as well. Well she didn't, so no shot. He tells me that's sounds exactly right, if in fact I was RH+ but I'm not. So this means, someone screwed up my blood tests, either this OB or my previous OB. He took more blood so they can retest it and said they will call me on Monday. So, if it comes back on Monday and I am in fact B+ and not RH+, WTH? That means my previous OB gave me the shot twice when it wasn't neccessary and they have my blood type wrong.... what if I needed a blood transfusion after givng birth? I mean seriously.... Does anyone know if any ill effects can happen due to taking the shot when it isn't needed??? DH is super pissed and talking about sueing but I told him that's a little overboard.
     
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    newmommy301978 responded:
    B+ is a blood type the positive meaning you have the rh factor and you don't need the rhogam shot, RH+ just means yu have the rh factor it isn't a blood type, so are you saying that your last dr told you that you were rh negative?
     
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    Jessica22738 responded:
    Yes and gave me the shot twice. Now this dr is telling me that I'm not.
     
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    newmommy301978 responded:
    ok just confused, that would really piss me off it sounds like more of a lab error though and not your dr unless they mislabeled your blood. I think sueing is not going to solve anything whats done is done but you could always call that office and let them know what happened.
     
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    Jessica22738 responded:
    I know, I was pretty angry when I found out. I think he'll leave it be once he cools down, I agree it's not going to solve anything and thankfully all parties involved came out umharmed. I'm going to call Monday once the results from my 2nd blood test come back but if the lab did screw up, they are so going to get a peice of my mind! I could've avoided two not so fun shots!
     
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    mlmynm81 responded:
    OMG thats scary! Im RH- and I need a shot when I get prego. I get mine durring and only if the baby is RH+ do I get it after delivery. Just because u have to get one during pregnancy doesnt mean u need one after, only if the babies blood is RH+. Thats really scary though, my DH was looking things up on Rhogam and if someone gets it that doesnt need it, it can be very harmful. Good thing nothing happened! Goodluck!
     
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    amhelblin9 responded:
    My doctor gave me the first shot at 28 weeks (I knew I was rh negative because I donate blood). After my son was born I received a second dose because he is rh positive (like his daddy).

    This pregnancy I was told the same sched. would be followed. So 28 weeks for the first shot and after delivery is #2 is rh positive.
     
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    Bailey98029 responded:
    I'm RH- as well and am surprised that they told you (when they thought you were RH-) that your baby would have to have a shot as well. If you are negative and your baby is negative then you are both compatible in which case you wouldn't have ever needed a shot to begin with and the baby most definitely wouldn't need a shot. It's the fact that when you are pg you don't know the baby's blood type that causes you to have the shot just in case. However, if they baby turns out negative you never need another shot after delivery. Whoever gave you that initial information most definitely didn't know what they were talking about or didn't explain the situation/treatment very clearly.

    I'm really sorry you had to go through that but am really glad you have a doctor that is on top of things this time around.

    Good luck to you!
     
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    AshtonNTysMom3 responded:
    Wow! When I went to school I had to take phlebotomy and did my clinicals in a hospital lab... mixing up a blood bank specimen is major! The phlebotomist and lab techs should be careful w/ patient ID w/ all specimens but any thing to do w/ blood typing is treated twice as careful there are special labels and ID bracelets (for in-patients) that was a major mistake not that the Rhogam would really hurt you but what if you needed a blood transfusion and they gave you the wrong blood type! I'm RH- and both of my boys are O+ they never got a shot, I've never heard of a baby recieving the shot.
     
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    Junesev responded:
    I'm RH- and have read a lot about it, plus have had a child before this pregnancy so I'm familiar with it. If you are B+ there definitely was no reason for you to have had to get the shot at all. BUT what worries me is that they were going to give your DD the shot! I've never heard or read that. Was it the same dr. you're going to now? If so I would seriously consider looking into a new one. I'm not a dr. or nurse but like I said, I've dealt with it and since I may have become sensitized as a result of my first I've really read a lot on it. I could be wrong though, it is definitely worth reading up on. I am positive though that if you are B+ there's no reason at all for it.
     
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    topazorchid responded:
    You need Rhogam if you are RH-
     
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    0o0ashley0o0 responded:
    Ok I am a Lab Tech and here's the deal. The Rh factor is actually what people are referring to with the + or - after the letter. B+ would be Rh positive, B- is Rh negative. When a mother is Rh negative that means that she doesn't have this specific antigen on her red blood cells. If her baby does get this antigen from the father and there is any mixing of mom and baby's blood mom will see this as foreign and can develop antibodies. This will not affect the current baby most likely, but if you get pregnant with another Rh positive baby the mom's antibodies can try to attack baby and baby may die or need transfusions after birth. All that Rhogam is, is a dose of the same antibody that mom would produce so that it can bind with any of the antigen in baby's blood to prevent her body from ever getting a chance to see it and make its own antibodies. I don't think it would be really harmful if you got it and you are in fact B+, the dose isn't high enough to really affect the number of red cells you have. It is pretty scary to have a mix-up in blood type though, that's serious business. The good news is that if they typed you Rh negative and you are in fact Rh positive it would not have hurt you to receive Rh negative blood, not that it makes it any better.
     
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    michl707 responded:
    Great and accurate information posted by OoOashleyOoO. Like Ashley, I have been a Medical Technologist for almost 15 years and currently work for one of the vendors who distributes the RhoGAM product.

    Let me further clarify: (1) The RhoGAM shot given to someone who does not need it will most likely not cause harm to you or your child. The 1/2 life of the preparation is approximately 30 days, so after 60 days, it will be completely eliminated from your system. No harm done. (2) While it is possible that this *may* have been a lab error, it just as easily *may not* have been. First, while someone may have mislabeled your sample of blood (ie. mixed up your blood with someone elses), it is extremely unlikely. You are B+ and you were typed previously as B-. Only 2% of the US population is B-negative, so it would be very unusual that you were mixed with a patient with such a low prevalence in the US. Second, it is now mandated in Blood Banks (where your blood is tested) have *2* types performed on every patient before the transfusion of any blood or blood products including RhoGAM. This however, may not have been in effect when you had your first child. Third, the technologies have improved significantly over the years. Some labs are still using a "traditional" technology, which would require an extra step to confirm the presence of the "D" antigen (if you have the "D" antigen, you are Rh-positive). Even with the extra confirmatory step, the test is not the most sensitive. Many labs today are using a GEL technology which is SO much more sensitive - people that typed as RH-negative in the past are typing as RH-positive today. This is not an error -- just a vast improvement in technology. You may also be what is referred to as having a "weak-D" - simply stating that you have only a "part" of the D antigen on your red cells. This is why you may have gotten conflicting blood types. (3) Research has shown that even if you have this "weak-D" expression, RhoGAM will NOT harm you. Some physicians tend to err on the side of caution and give their patients the RhoGAM even if they have this "weak-D". There is nothing wrong with that! (4) You said you were @ 30 weeks. That does seem a little late to me, as most products are given between 26-28 weeks. However, there is one vendor on the market whose product is given between 28-30 weeks, so that may be the one that you are getting.

    So, please don't give the lab a "piece of your mind". Understand that technologies have improved and that you and your baby have not been harmed. Suing will cause more harm than good - I don't think you would have much of a case.

    The RhoGAM shot is given to help prevent HDN - Hemolytic Disease of the Newborn. It has been extremely effective over the years and has saved tens of thousands of babies from this disease. While they may not die from the disease, it is NOT fun to spend weeks in the NICU with your little one.

    Hope this helped - good luck to you!
     
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    topazorchid responded:
    You either have a positive blood type, and are RH+ OR you have a negitive blood type, and are RH-. You only need Rhogam if you are RH-.
     
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    tfarnon replied to michl707's response:
    We just encountered this situation where I work, and it was incredibly crazy-making until we got it all sorted out. The patient had been typed by gel typing maybe two years prior as Rh negative, so that's what was on file in our system. The patient came in to deliver a second baby a couple of weeks ago, and there were other abnormalities found in other sections of the lab, so there was a lot of retesting and even a re-draw and retesting, which made the doctor think we didn't know what we were doing. The abnormalities were "normal" in light of the patient's status, and that was all resolved to everyone's satisfaction.

    Then came the routine confirmation of ABO/Rh, and again, the patient tested Rh negative. Okay. The newborn's sample for testing (HDN prophylaxis), and the infant was Rh positive. That triggered the reflex maternal fetal screen test, which came up positive, requiring re-testing of the mother's Rh results, this time with weak D as well as the routine gel test. The weak D test came up positive, so we had to re-test with weak D to confirm, both the prenatal and postnatal sample. The mother was definitely weak D positive, so that's what got reported out, with a reflex to the fetal stain test. The fetal stain test was also positive (barely), so our system indicates that even though RhoGam isn't indicated, we need to make the doctor aware that RhoGam is available. Well, that triggered another round of doctor skepticism. First the other tests were abnormal and had variable results, and now the blood typing had changed? Yeah, that was fun to explain, too.

    At least it all got clarified in the end, the doctor decided to give RhoGam anyways (it's the doctor's call, and arguments can be made for both giving and not giving RhoGam here), and the mother's record was annotated to ensure that she only receives Rh negative blood should she require transfusion, even though her record now indicates that she is Rh positive.

    It was kind of crazy-making, very interesting, and everyone just loves the "look at this!" huddles. At least everyone in the blood bank loves them. It's just cool to get something unusual, especially if it either doesn't hurt the patient or our findings help the patient.


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