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Discussion Starter #1
I am new to this site and I found lots of useful information in here..

I was diagnosed with Lupus Nephritis 2 years back and am on Immuran for a while now. I got pregnant recently and for some reason miscarried in like 3-4 weeks of pregnancy. I have been bleeding now for about 12 days. To make things even worse, my blood group is A negative and so my gynecologist wants me to have a Rhogam shot.

I am not sure if it can be taken with Immuran. I would definitely check with my doctor before taking it, but has any of you come across this situation? Is there any precautions that I should take if I am to take the shot? Does it cause any infection or what to expect after taking the shot? I am scheduled to travel abroad early next week (in 5 days)

Any help is greatly appreciated.
 

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Hello!

I can't speak to the possible interaction between Rhogam and Imuran, but I do have experience with the Rhogam injection. I have O- blood, and was given Rhogam when I was 28 weeks pregnant with my second child. My first child had A- blood, and the second had O-, so I did not need any other rounds of Rhogam.

Rhogam prevents a woman with Rh negative blood from producing antibodies to Rh positive blood. This can happen if the baby has Rh positive blood, and the baby's blood mixes with the mother's, either during pregnancy or during delivery. If the mother develops antibodies to Rh positive blood, this can cause problems during future pregnancies.

The Rhogam injection is usually given into muscle (typically your bottom), and is a bit painful. It gave me a burning sensation that lasted about an hour. The injection site felt warm and tender for a few days. There should be no concern for infection at the injection site as long as the area is properly disinfected.

Hope that helps!

Terri
 

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I wanted to recheck my memory so here is a link:

http://miscarriage.about.com/od/treatmentrecovery/f/rhogam.htm

Basically, after 12 days, you are unlikely to reap any benefit from the Rhogam shot. You should get it within 72 hours of birth or miscarriage or stillbirth if the baby has + blood especially. It is also unlikely to be truly necessary when you miscarry this early as the mixing of fetal blood with your blood is very unlikely but they just universally recommend it anyways as they believe any risk/adverse effects from the Rhogam shot are quite minimal.

I also have A- blood, but had an A- daughter, so have not needed the shot. I actually declined the 28 week shot when they offered it to me because I knew the risk from a first pregnancy was extremely low, and I knew I might have an A- child, and had some slight concerns about immune reactions I may have to a blood product although my doctors told me there was next to no reason to be concerned about it.
 

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Discussion Starter #5
Thanks for all your replies..

Maia, The doctor was aware that I was bleeding for about 12 days but she asked me to take it in the next couple days. I am not sure how effective it will be if I take it now, Will it even help the next time or it is going to mislead the next time I am pregnant?. I began bleeding in 4-5 weeks of pregnancy, not sure if that is too early to be sensitized.
 

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Sometime in the very near future, you could be tested to see if you have become sensitized via a blood test. Then you would know. Getting the shot now would *not* "mislead" the test the next time you are pregnant. This shot contains antibodies that are of the first type to be produced by your body if you were exposed. The idea behind the shot is that because you are "given" them... your body does not manufacture it's own antibodies since it doesn't need to. Therefore, your body does not produce the first type, and will therefore not produce the second type which has a memory built into it which is what causes risk to second/subsequent pregnancies.

I have to seriously question the usefulness of the Rhogam shot for you now as the statistics I am remembering suggest the risk of sensitization at that early stage of pregnancy is very low (it increases very slightly after 8 weeks gestation from practically zero risk before that), and I have to believe that 2 weeks after the fact is probably too late for the shot to work if you have been sensitized.

I would have a very serious discussion with your doctor about the utility of getting this shot now considering these two factors before you get it. I can understand your apprehension about it for those reasons.
 

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Discussion Starter #7
I called my doctor's office again y'day and asked them if it will be useful even if I take after 12 days.. They told me that it would be useful and asked me to get it soon.. So I did get my shot this morning after confirmation from my Nephrologist about the any possible interaction with Immuran..

Thanks for your replies !!
 
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