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It's most known in the medical community by its four letter abbreviation, HDFN, or Hemolytic
Disease of the Fetus and Newborn.
As recently as the mid 1906s, HDFN would cause nearly 10,000 infant deaths a year in the
United States.
HDFN has been virtually eliminated in developed countries thanks to an intervention that could
prevent it from happening, which we're going to learn and talk about today.
Dr. Larry Griffin is an Obstetrician with Women's Care Physicians of Louisville.
He's an Associate Clinical Professor at the University of Louisville School of Medicine,
and Former Director and Vice President for the American College of Obstetricians and
Gynecologists.
Dr. Griffin, welcome.
It is so great to have you in the studio today.
Thank you.
You know, HDFN, let's begin with that.
Really, just explain to me right off the bat what it is.
HDFN begins with a blood type mismatch between a pregnant mother and her developing baby.
Each of our blood cells carries a set of proteins that determine our blood type.
One of those proteins called rhesus, Rh, or D antigen can cause an immune reaction in
Rh negative women who don't have that protein on their red blood cells.
Here's the scenario.
When an Rh negative mother is pregnant with an Rh positive baby, during nearly all pregnancies
a small number of fetal red blood cells cross the placenta and enter the maternal circulation.
The initial immune reaction typically doesn't cause a problem with an Rh negative woman's
first pregnancy, but she's now considered sensitized.
During the next pregnancy with an Rh positive baby, the continued response results in antibodies
that cross the placenta and destroy the Rh positive red blood cells and the developing
fetus, leading to HDFN.
HDFN pregnancies are at high risk of fetal anemia, still-birth, and serious neonatal
and pediatric complications including disability or death.
Doctor, before 1968, over 10,000 babies died each year in the United States due to HDFN.
Tell us really how things have changed when scientists developed a product that could
prevent Rh sensitization.
It turns out that giving Rh antibodies, referred to as Rh immunoglobulin to Rh negative women
before they're exposed to Rh positive blood can prevent the development of that response.
The first Rh immunoglobulin product approved in the U.S. was RhoGAM.
RhoGAM is a prescription medicine that your doctor can prescribe if it's right for you.
When administered at the right times, RhoGAM can drastically reduce the incidents of HDFN.
There are some general safety considerations that you should know.
RhoGAM should always be given to the mother and never to the baby.
Adverse events after administration of RhoGAM are rare, but there is a risk of allergic
reactions if you've had an allergy to immunoglobulins or if you have an IgA deficiency.
Adverse reactions may include redness, swelling, mild pain at the injection site, and some
patients have experienced elevated body temperature following administration.
You're encouraged to talk to your doctor if you experience any of these symptoms after
receiving RhoGAM.
Now because HDFN affects babies of women who are Rh negative, what do they need to know
in order to proactively ensure they're getting Rh immunoglobulin at the right time during
their pregnancy?
The American College of Obstetricians and Gynecologists recommends that Rh negative
women be given a dose at 28 weeks of pregnancy and another dose after delivery if the newborn's
Rh positive.
Women should also be aware that if they undergo any type of invasive procedure, such as amniocentesis
or have any significant abdominal trauma, an additional dose may be required.
Well based on what you've told us, Rh immunoglobulin was a game changer in the field against HDFN.
Tell us, Doctor, something about how this life saving product is made.
Rh immunoglobulin is purified from human plasma from specific donors who have anti Rh antibodies
circulating in their bloodstream.
It's important to point out that since all plasma derived products are made from human
blood, they may carry a risk of transmitting infectious agents such as viruses and theoretically
the Creutzfeldt-Jakob disease agent.
So far, there have been no documented cases of viral transmission with RhoGAM.
Wow.
This is really vital information and so important.
And when we come back, we're going to meet a woman who, years ago prior to the availability
of Rh immunoglobulin, suffered the emotional consequences of Rh sensitization.
She's here to share her story and also what she's doing now to help other mothers-to-be.
Don't go away.
We'll be right back.
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Well, we're back and speaking with Dr. Larry Griffin, an Obstetrician with Women's Care
Physicians of Louisville.
And joining us now is Ellen Conrad, a woman whose personal experience initiated her lifelong
commitment to helping other women and their babies.
Ellen, I want to thank you so much for coming in.
We loved talking to the doctor.
And right off the bat, I just want you to tell us your story.
My first pregnancy was easy.
It resulted in a healthy baby boy.
The next pregnancy was a much different story.
I get emotional now, 44 years later, as I think of how close we came to losing the second
son.
During my first pregnancy, Rh immunoglobulins were not available.
When I became pregnant again, my doctor explained to me that my Rh negative blood was attacking
the blood of my baby in my womb.
At that time, the treatment for HDFN was blood transfusions.
The hospital was ready with life saving blood transfusions as soon as my son was born.
My son had two transfusions in the first days of his life.
After the Rh antibody cleared his system, he developed into a normal healthy baby.
Oh, I know that was hard for you to tell.
That's just such an emotional story.
And how is it that Ellen, because of her history with HDFN, is such a valuable resource for
other Rh negative mothers today?
Well, Ellen, like other Rh negative mothers who've had Rh positive children, is now sensitized
and has anti Rh antibodies circulating in her bloodstream.
These antibodies are collected to make Rh immunoglobulin.
In the case of RhoGAM brand, source plasma comes from a group of approximately 400 donors.
Plasma donations are collected at Somerset Labs.
Oh, and I've heard that Somerset Labs is a pretty special place.
I know it is for you, Ellen.
Tell us about that.
Well, Somerset Labs is a wonderful place, and all of the donors are proud to know that
we are making a difference in the lives of pregnant women and their sweet little babies.
We typically go twice per week to donate our plasma.
Somerset is near Buffalo, New York, which is not known for great weather, but rarely
stops us from getting there.
The staff at Somerset care about us.
We're like family.
I've been donating my plasma for over 27 years, and it has been estimated that the plasma
I have donated for RhoGAM brand has spared thousands of babies from HDFN.
That is just an amazing story.
With all that you've been through and all that you've given back, is there anything,
Ellen, that you'd like to share as we close for women watching today?
I'm just thankful that something very good came out of my trying experience and that
I can make a difference.
Doctor, any final thoughts from you?
All pregnant women, or women who are thinking of becoming pregnant, should get prenatal
care including an evaluation of their blood type.
I'd like women to know that there are options for preventing HDFN that can be discussed
with their physician.
RhoGAM is one such option.
You can get more information from your doctor or by visiting www.RhoGAM.com.
Oh, I want to thank you both for coming in.
Ellen, for what you're doing, for your donations, for all of the families and mothers and dads
that you've helped out there.
And Doctor, thank you, too.
It's just been a moving experience.
And thank you for sharing it with us.
I know it was difficult.
You're welcome.
But you're making a difference and so are you.
And if you'd like more information, please visit us at TheBalancingAct.com
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