Glossary

Term · Loss and Complications

Rh immune globulin

Also: RhIG, Rho(D) immune globulin, the Rh shot

A blood product given to Rh-negative people that lowers the chance of antibodies against Rh-positive blood. It is given in pregnancy, after some losses, and after some births.

In plain words

Rh immune globulin is a preparation made from donated human plasma. It is given to people who are in certain situations, so that their immune system is less likely to form antibodies against Rh positive blood. These antibodies can affect a later pregnancy. It is used in pregnancy around 28 weeks, after the birth of an Rh-positive baby, after a or abortion, and after certain bleeding or procedures. Guidance changes over time. For example, a 2024 ACOG update says it is not needed after losses before 12 weeks, while other bodies may differ. Ask your provider whether it applies to your situation and what your Rh status is. The shot is sometimes called the Rh shot, and brand names such as are used too.

The deeper version

Rh D immune globulin is a polyclonal antibody preparation derived from human plasma. It suppresses the primary immune response to D-positive red cells in D-negative recipients, through clearance of antigen-bearing cells, a mechanism well established but not fully explained. Indications include antenatal prophylaxis at about 28 weeks, postnatal use after delivery of a D-positive infant, and use after pregnancy losses, or molar pregnancy, abdominal trauma, and procedures. ACOG Practice Bulletin 181 (2017) set the framework, and a 2024 ACOG clinical practice update states that Rh D immune globulin is not needed for losses before 12 weeks, while recommendations from other bodies vary by loss type and gestational age. Evidence for antenatal use is strong, and the debate concerns loss-related thresholds and the role of fetal genotyping.

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Sources

  • American College of Obstetricians and Gynecologists — Practice Bulletin No. 181: Prevention of Rh D Alloimmunization (2017)
  • American College of Obstetricians and Gynecologists — Clinical Practice Update on Rh D immune globulin (2024)

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