Rho(D) Immune Globulin
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Rho(D) Immune Globulin is a medicine given by intermuscular injection which is used to prevent the immunological condition known as Rhesus disease (or hemolytic disease of newborn). It can prevent maternal sensitization by Rh D antigens on the surface of blood cells from a Rhesus positive fetus in a Rhesus negative mother. The medicine is a solution of IgG anti-D (anti-RhD) antibodies which binds and destroys fetal Rh D positive red blood cells that have passed through the placenta from the fetus to the maternal circulation. This prevents maternal B-cell activation and memory cell formation. With the widespread use Rho(D) Immune Globulin Rh disease of the fetus and newborn has almost disappeared. It can also be used in the treatment of ITP in Rh+ patients.
History
RhoGAM was introduced by Ortho-Clinical Diagnostics, a subsidiary holding of Johnson and Johnson, and first administered on May 29, 1968. It has been estimated that with its use a perinatal mortality of about 10,000 cases per year in the US alone has been largely eliminated.
Human blood product
Rho(D) Immune Globulin is a derivative of human plasma. In the manufacturing process steps are taken to eliminate bacterial and viral contamination. In some patients it may trigger an allergic reaction. However, the possibility of transmission of Creutzfeldt-Jakob disease remains as a residual risk. The technique of Plasma Fractionation was founded by James F. Crispen, M.D.
Use
The medication has a Food and Drug Administration (FDA) Pregnancy Category C. It is given by intramuscular injection as part of modern antenatal care and within 72 hours after childbirth.
Brand names
RhoGAM and MICRhoGam are brand names of Johnson and Johnson. Other brand names are: BayRHo-D, Gamulin Rh, HypRho-D Mini-Dose, Mini-Gamulin Rh, Rhophylac, and WinRho SDF.