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Fungi - Morphology, Reproduction, Physiology and Importance in Simple Words

By Momina Shehzadi | BS Zoology Graduate, Pakistan In this article, we will learn Fungi - Morphology, Reproduction, Physiology and Importance - in simple words with diagram. This topic is very important for BS Zoology and Microbiology students. Fungi are found everywhere around us. They are present in soil, in water, in air, on dead plants, on dead animals, on our food, on our skin and even inside our body. When bread becomes old, green or black spots appear on it. These spots are fungi. When we see mushroom growing after rain, that is also a fungus. When yeast is used to make bread soft, that is also a fungus. Fungi are very different from bacteria and plants. They are eukaryotic organisms. It means their cells have a true nucleus and other membrane bound organelles. They do not have chlorophyll, so they cannot make their own food like plants. They get their food from other living or dead things. That is why they are called heterotrophic organisms. The study of fungi is called mycolog...
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What is Rhogam Injection? - Dose, Timing and Prevention of Erythroblastosis Fetalis | BS Zoology

By Momina Shehzadi | BS Zoology Graduate, Pakistan

In this article, we will learn What is Rhogam Injection - How it Prevents Erythroblastosis Fetalis - in simple words with dose and schedule. This topic is very important for BS Zoology, Medical and Nursing students.
Diagram by Momina Shehzadi, BS Zoology Graduate, showing How Rhogam Injection Prevents Erythroblastosis Fetalis. Rh negative mother receives Rhogam, ready-made Anti-D antibodies destroy Rh positive fetal RBCs, mother makes no antibodies, next baby remains safe.


Introduction

In our previous post, we discussed Erythroblastosis Fetalis, a severe disease of newborn caused by Rh incompatibility between Rh negative mother and Rh positive fetus. The question now is, can this fatal disease be prevented? Yes, it can be 100% prevented by a special injection called Rhogam or Rh Immune Globulin. For every Rh negative mother, knowledge about Rhogam injection is life-saving for her next baby. Before Rhogam, thousands of babies died every year.

What is Rhogam Injection?

Rhogam is a brand name for Anti-Rh(D) Immune Globulin (RhoGAM). It is a sterile solution made from human plasma that contains ready-made IgG antibodies against Rh-D antigen.


It is important to note, Rhogam is not a vaccine that stimulates your own immunity. It is passive immunity - means ready-made antibodies given from outside. When it is injected into Rh negative mother, it destroys any Rh positive fetal RBCs that may have entered her circulation before her own immune system can recognize them and make its own permanent memory antibodies.

Mechanism of Action - How Rhogam Prevents Erythroblastosis Fetalis?

This is the most important concept for exam. Understand step by step:


1. Entry of Fetal RBCs: During delivery, miscarriage, abortion, amniocentesis or even silently in third trimester, a few fetal Rh positive RBCs enter mother's Rh negative blood. Even 0.1 ml fetal blood is enough.


2. Normal Immune Response Without Rhogam:

 Normally mother's immune system is slow. It would take 2-6 weeks to make Anti-D IgG antibodies (Primary response). Once these antibodies are made, they become Memory cells and stay for lifetime. In next pregnancy with Rh positive baby, these memory cells make huge amount of IgG quickly, which crosses placenta and destroys fetal RBCs causing Erythroblastosis Fetalis.


3. Action of Rhogam:

If we inject Rhogam (ready-made Anti-D IgG) within 72 hours of delivery, these injected antibodies will find and destroy all fetal Rh positive RBCs in mother's blood within few hours by hemolysis in spleen. Because fetal RBCs are destroyed quickly, mother's immune system never gets chance to see Rh antigen. So mother's immune system never gets activated and never makes its own antibodies and memory cells. So next pregnancy remains completely safe.


This unique principle is called Antibody Mediated Immune Suppression (AMIS). We give antibody to prevent making of antibody.

When is Rhogam Given? - Dose Schedule for Exam

This is most asked in BS Zoology and nursing exams:


1. Routine Antenatal Prophylaxis Dose:

At 28 weeks of pregnancy, 1 full dose (300 mcg or 1500 IU) is given intramuscularly to all Rh negative mothers as routine prophylaxis, even if there is no bleeding history. Why 28 weeks? Because small silent Fetomaternal Hemorrhage (FMH) can happen in third trimester without any symptoms. This dose covers till delivery.


2. Postnatal Dose:

Within 72 hours after delivery of Rh positive baby, another full dose 300 mcg IM is given. First, baby's blood group is checked from cord blood. If baby is Rh positive, mother gets Rhogam. If baby is Rh negative like mother, no need for postnatal dose.


3. After Other Sensitizing Events:

After any event where fetal blood can mix, a smaller dose (50 mcg or 250 IU) or full dose is given within 72 hours:

- After miscarriage before 12 weeks: 50 mcg

- After miscarriage after 12 weeks, abortion, ectopic pregnancy: 300 mcg

- After amniocentesis, CVS, cordocentesis: 300 mcg

- After antepartum bleeding: 300 mcg


Golden Rule:Best time is within 72 hours, but if missed, ACOG says it can still be given up to 28 days after delivery with some benefit. So never say it's too late, give it.

Who Needs Rhogam? - Indications

- Mother is Rh negative (genotype rr) and Father is Rh positive (RR or Rr)

- Mother is Rh negative and baby is confirmed Rh positive after birth

- Mother is Du negative / Weak D positive - also needs Rhogam as per new guidelines, considered Rh negative for pregnancy purpose.

- Mother is Rh negative and had any bleeding during pregnancy.

If both mother and father are Rh negative, baby will also be Rh negative, so no need for Rhogam.

Does Rhogam Have Any Side Effects? Is it Safe?


Rhogam is very safe. It is made from highly screened human plasma. Donors are tested for HIV, Hepatitis B, C. Manufacturing process includes viral inactivation. Mild side effects: soreness at injection site, slight fever, mild rash. It does not harm mother or fetus because it is IgG antibody, it does not cross to fetus in large amount to cause harm. It does not contain live virus, so cannot cause infection. It is FDA category C but considered safe in pregnancy.

Importance and History - Success Story of Immunology

Before 1968, when Rhogam was introduced by Dr. Vincent Freda and colleagues, Erythroblastosis Fetalis caused death of about 10,000 babies per year in USA alone and many were mentally retarded due to kernicterus (bilirubin in brain). After introduction of Rhogam in 1968, incidence reduced by more than 99%. This is one of biggest success stories of preventive immunology. In Pakistan, still many cases happen because Rh negative mothers do not get Rhogam due to lack of awareness.

Conclusion

Rhogam injection is a perfect example of medical prevention is better than cure. For BS Zoology students, always remember this line for exam: Rhogam provides PASSIVE immunity to prevent ACTIVE immunity of mother. Remember dose: Routine dose at 28 weeks and within 72 hours after birth of Rh positive baby. 300 mcg IM.

FAQs about Rhogam Injection - For BS Zoology Students

Q1: What is Rhogam injection used for?

Rhogam injection is used to prevent Erythroblastosis Fetalis in next pregnancy. It is given to Rh negative mother whose baby is Rh positive to stop her immune system from making permanent Anti-Rh antibodies.

Q2: Is Rhogam a vaccine or antibody?

Rhogam is NOT a vaccine. It is ready-made Anti-D IgG antibodies (passive immunity) made from human plasma. It gives immediate protection but does not create memory. Its purpose is to prevent mother from making her own active immunity.

Q3: When should Rhogam be given? Dose schedule?

Two main doses: First routine dose at 28 weeks of pregnancy (300 mcg IM) and second dose within 72 hours after delivery of Rh positive baby. After miscarriage, abortion or amniocentesis, it is given within 72 hours (50-300 mcg).

Q4: What happens if Rhogam injection is missed within 72 hours?

Best effect is within 72 hours, but according to ACOG guidelines, it can still be given up to *28 days after delivery* with some benefit. So it should be given even if 72 hours have passed. Never skip it.

Q5: Who needs Rhogam injection?

Any Rh negative pregnant woman (rr) whose husband is Rh positive (RR/Rr) and whose baby is Rh positive after birth. If both mother and father are Rh negative, no need for Rhogam.

Q6: Does Rhogam have side effects? Can it harm the baby?

Rhogam is very safe. It is screened for HIV and Hepatitis. Mild side effects include pain at injection site and mild fever. It does not harm mother or breastfeeding baby. It does not contain any live virus.

Q7: What is the price of Rhogam injection in Pakistan?

In Pakistan, Rhogam 300 mcg costs around 3000 to 6000 PKR. It is available at all major medical stores and hospitals. It is a life-saving injection, cost is nothing compared to saving next baby.

Note: The price of Rhogam injection varies according to brand and market. Please confirm the current price from your nearby medical store or hospital pharmacy.


Also Read: What is Erythroblastosis Fetalis? - Causes, Symptoms and Treatment

Also Read: Blood Transfusion - Types, Procedure and Compatibility Chart


Note: This topic is explained from my BSc Zoology notes for educational purpose. I made this diagram during my studies. For medical treatment and dosage, please consult your doctor. 

Written by Momina Shehzadi, BS Zoology Graduate from Pakistan.

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