Blood Bank Guy Essentials Podcast 099: Rh Immune Globulin (Teaching Episode)
Feb 1, 2023
In this insightful talk, Jessica Hudson, a third-year pathology resident passionate about transfusion medicine, simplifies the complexities of Rh Immune Globulin (RhIG) dosing. She and Joe explain the critical need for accurate dosing to prevent at-risk mothers from developing anti-D antibodies. They introduce the 'five over three' calculation tool and discuss the mechanics behind hemolytic disease of the fetus and newborn, RhIG's role, and its timing during pregnancy. Additionally, they touch on the different RhIG formulations and the importance of postpartum checks.
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Administer RHIG At The 28‑Week Visit
- Give RHIG at about 28 weeks to protect against third-trimester fetal–maternal hemorrhage.
- Always check an antibody screen at the 28-week visit before dosing.
Memorize The 5/3 RHIG Shortcut
- One 300 µg (1500 IU) RHIG vial covers 30 mL of D-positive whole blood or 15 mL of packed RBCs.
- Memorize "five over three for RHIG" to simplify dosing calculations.
RHIG Mechanism Is Not Fully Known
- The precise mechanism of RHIG prevention of alloimmunization remains uncertain.
- RHIG likely binds fetal cells and alters maternal immune response, but full explanation is unknown.