Rh Incompatibility Between Mother And Child Need Rh Immune Globulin

[skeetaboat]

Hi all,

Just wondering if anyone has had an RH incompatible pregnancy in thailand (or any other part of asia) it's a condition where the mother has o negative blood and the fetus has o positive blood, leading to possible rejection of the child by the mother (usually in second pregnancies).

To avoid the rejection, you must have an injection of RH immune globulin during the pregnancy and after the birth.

Because most mothers in Thailand have o positive blood, this is a rare problem in Thailand and I need to find rh immune globulin. Anyone had this experience in thailand or know about the availability of rh Immune globulin in asian countries?

Thx,

Skeet

[cathyy]

I don't want to discount the importance of the rh factor imcompatibility, but you CAN do without the injections if you must. It just vastly increases the risk for any subsequent babies.

The worst case scenario is the mother becoming sensitized to the rh positive blood cells of the baby during the pregnancy (usually due to a previous pregnancy) and her immune system attacking the baby's red blood cells, necessitating an early delivery and complete blood transfusions for the baby.

More important than the immune globulin is the sensitivity (titre) testing every 4 weeks for the Mom. Get the Mom tested for her level of sensitivity (her titre) to gauge how much a problem you seem to actually have. Then you can tell if the baby is in danger or not. If the titre is low, and stays low, that's excellent. It will mean nothing for a subsequent baby, though, as she will definitely be exposed to fetal blood during delivery and is likely to become much more sensitive a couple months later if she doesn't get the immune globulin at delivery.

[skeetaboat]

Hi Cathy, Thanks for the info, it's good to know if I can't get some Rh anti-D. In the long run though I think it would be easier to have the tranfusion than monthly tests. Have you heard of a hospital in Thailand that does do the titre test?

Skeet

[lannarebirth]

My sister was born in 1969 and my mother had the RH problem you describe. I remeber the doctor started her on something called Rhogam, which at the time was quite new. I just googled it and see it's still used.

http://www.rhogam.com/English/Patients/index.aspx

[skeetaboat]

My sister was born in 1969 and my mother had the RH problem you describe. I remeber the doctor started her on something called Rhogam, which at the time was quite new. I just googled it and see it's still used.

http://www.rhogam.com/English/Patients/index.aspx

Rhogam is given routinely in the west for pregnant women in with Rh negative blood - the problem is that it's not widely available in Thailand where most people have rh positive blood, I can't find a supplier in thailand, and most doctors here don't know where to get it. Thanks for the website - I'll contact them and see if I can order it in!

Edited November 17, 2006 by skeetaboat

[cathyy]

Yep, Rhogam is the immune globulin stuff. I do hope you can get some of it! Prevention is the best way to treat this.

Is this her first pregnancy? Has she ever before been pregnant, but had a miscarriage or abortion? Has she ever had a blood transfusion? These are factors that increase the risk due to possible exposure to rh positive blood.

I would suggest a trip to a Bangkok hospital with some European doctors. (Bumrungrad?) They will be familiar with the whole rh thing. She should be able to get her sensitivity to rh positive blood tested there, and they ought to know how to treat a baby affected by this if the immune globulin can't be gotten.

[leisurely]

Wise words Cathy. Skeeta can stay at ours if she needs to. I am in email contact with her and will suggest that to her. there is no point jepordising the health of mother or child when airdelaysia does such a cheap flight to the capital.

[Sheryl]

Have you checked Samitivej and Bumrungrad Hospitals? Both have a lot of foreigners delivering there, hard to believe they wouldn't have Rhogam.

[samran]

Have you checked Samitivej and Bumrungrad Hospitals? Both have a lot of foreigners delivering there, hard to believe they wouldn't have Rhogam.

My wife had her rh injections at Samtivej, and her friends have had it at Bamrungrad.

So they are available, though Samitivej charged us 12,000baht a pop for each of them!

Small price to pay for the safely of you babies and subsequent ones though.

[skeetaboat]

Have you checked Samitivej and Bumrungrad Hospitals? Both have a lot of foreigners delivering there, hard to believe they wouldn't have Rhogam.

My wife had her rh injections at Samtivej, and her friends have had it at Bamrungrad.

So they are available, though Samitivej charged us 12,000baht a pop for each of them!

Small price to pay for the safely of you babies and subsequent ones though.

Hi All, thanks for your input. I've finally heard back from the hospitals - both Bumrungrad in BKK have it (for $300 US!! ) but Chiang Mai Ram here in Chiang Mai also have it for 3,000 baht. Thanks again.

[skeetaboat]

Some further info in-case someone searches this topic down the track..

I ended up getting RhoGAM Anti-d at the RCH ward, 5th floor of the Sripat Clinic at Maharaj Hospital on Suthep Road in Chiang Mai. (Sripat is the newest part of the hospital, and the hospital is also sometimes referred to as Suan Dok Hospital).

The doctors at the RCH clinic on the 5th floor knew more about Rh incompatibility and Anti-D treatement than the other hospitals I'd been to ("Mee le Dek" Mother and Child Hospital and Chiang Mai Ram), and gave me the coombs test before ordering RhoGAM Anti-D immunglobulin. (The coombs test is a blood test which will tell you if there has been any maternal exposure to fetal rh positive blood - if the test comes back negative, RhoGAM will be effective treatement, if the test comes back positive, your pregnancy is high risk and you'll need weekly monitoring and tests to make sure that your body isn't attacking your baby's red blood cells). One of the head nurses and all of the doctors in the RCH clinic spoke excellent English, but if you have any communication difficulties, head to the 13th floor where staff English skills are better and wait time is shorter - though you may be charged more as this is a private clinic.

The coombs test and the RhoGAM at Sripot Clinic, Maharaj: 4,300 baht.

Warning: Maharaj has little car parking available, and all their signs are in Thai. PM me if you'd like more info.

Edited March 11, 2007 by skeetaboat