Agents that suppress the immune system play an important role in preventing the rejection of organ or tissue grafts and in the treatment of certain diseases that arise from dysregulation of the immune response. While precise details of the mechanisms of action of a number of these agents are still obscure, knowledge of the elements of the immune system is useful in understanding their effects. Agents that augment the immune response or selectively alter the balance of various components of the immune system are also becoming impor-tant in the management of certain diseases such as cancer, AIDS, and autoimmune or inflammatory diseases. A growing number of other conditions (infections, cardiovascular diseases, organ transplanta-tion) may also be candidates for immune manipulation.
A 30-year-old woman has one living child, age 6. Her child and her husband are Rh positive and she is Rho(D) and Du negative. She is now in her ninth month of pregnancy and is in the labor room having frequent contractions. Her Rhantibody test taken earlier in the pregnancy was negative. What immunotherapy is appropriate for this patient? When and how should it be administered?
Within 24–72 hours postpartum, the woman should be given a 2-mL intramuscular injection of 300 mcg anti-Rh o(D) immune globulin. This will clear any fetal Rh-positive red cells from her circulation so she does not generate antiRho(D) B cells that might jeopardize any future pregnancy.