Practice of Medicine
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Risk Alert: New Information to Help Physicians Manage RhoGAM Shortage
The ongoing shortage of RhoGAM® in the U.S. remains a major challenge, prompting many providers to explore alternative strategies to mitigate the impact on patients with Rh incompatibility. To support those efforts, we’re providing the latest guidance and recommendations for managing risks during the shortage.
New Clinical Practice Update from ACOG
ACOG recently released a Clinical Practice Update based on new studies that suggest a very low risk of Rh alloimmunization following abortion or pregnancy loss at less than 12 weeks’ gestation. One of the key recommendations is to forego routine Rh testing and RhIg prophylaxis in this patient population.
The new studies add to the understanding of the risks and benefits of RhoGAM for pregnancy loss and abortion. While the studies weren’t related to the RhoGAM shortage, the revised ACOG guidance based on them could consequently reduce the demand for RhoGAM and help alleviate the shortage.
More details are available in the update: Rh D Immune Globulin Administration After Abortion or Pregnancy Loss at Less Than 12 Weeks of Gestation).
Recommendations and Resources for Risk Mitigation during the Shortage
- Follow the latest guidelines for administering RhoGAM
- Keep a close eye on inventory and usage
- Consider alternative medications for Rh incompatibility
- Perform paternal testing (with known/certain paternity)
- Perform non-invasive prenatal testing to determine the baby’s Rh status
Additional resources that may be helpful include:
- ACOG Practice Advisory March 2024: Rho(D) Immune Globulin Shortages
- UT Southwestern Medical Center April 2024: RhoGAM Shortage: Managing Rh incompatibility in pregnancy
- ACOG Practice Bulletin: Prevention of Rh D Alloimmunization
- UpToDate® Guidance:* RhD alloimmunization: Prevention in pregnant and postpartum patients
Following those guidelines and recommendations, informing patients of their options and documenting all conversations will help physicians manage the risks associated with the shortage while still offering optimal care to patients with Rh incompatibility.
*UpToDate is available to MagMutual policyholders. If you aren't registered to use it, visit our webpage to learn more.
09/24
Disclaimer
The information provided in this resource does not constitute legal, medical or any other professional advice, nor does it establish a standard of care. This resource has been created as an aid to you in your practice. The ultimate decision on how to use the information provided rests solely with you, the PolicyOwner.