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Exposure to fetal blood cells that can cause RhD alloimmunization can happen during normal pregnancy and delivery, miscarriage, amniocentesis, cordocentesis, chorionic villus sampling, external cephalic version, or trauma. [3] [8] 92% of women who develop an anti-D during pregnancy do so at or after 28 weeks gestation. [11] [9] [12]
Blood compatibility testing is routinely performed before a blood transfusion.The full compatibility testing process involves ABO and RhD (Rh factor) typing; screening for antibodies against other blood group systems; and crossmatching, which involves testing the recipient's blood plasma against the donor's red blood cells as a final check for incompatibility.
The FDA approved the drug under the brand name RhoGAM, with a fixed dose of 300 μg, to be given within three days (72 hours) postpartum. Subsequently, a broader peripartum period was approved for dosing which included prophylaxis during pregnancy. Within a year, the antibody had been injected with great success into more than 500,000 women.
Pregnancy itself is a factor of hypercoagulability (pregnancy-induced hypercoagulability), as a physiologically adaptive mechanism to prevent post partum bleeding. [41] However, when combined with an additional underlying hypercoagulable states, the risk of thrombosis or embolism may become substantial.
Newborn Screening Tests - Transfusion with donor blood during pregnancy or shortly after birth can affect the results of the Newborn Screening Tests. It is recommended to wait and retest 10–12 months after last transfusion. In some cases, DNA testing from saliva can be used to rule out certain conditions. [citation needed]
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[1] [2] [3] Pollack co-developed the vaccine, also known by the RhoGAM brand name, which is given to pregnant women to prevent Rh disease, with Dr. Vincent Freda and Dr. John G. Gorman of Columbia-Presbyterian Medical Center. [1] Pollack's vaccine, introduced in 1968, virtually eliminated cases of Rh disease in developed countries. [1]