Final answer:
The client with Rh-negative blood should receive RhoGAM at 28 weeks' gestation and within 72 hours after delivery to prevent Rh isoimmunization. Timely administration of RhoGAM is key to reducing the risk of hemolytic disease of the newborn (HDN).
Step-by-step explanation:
To help prevent Rh isoimmunization in the case where the client's blood Rh is negative and her partner's is positive, the client should receive RhoGAM at 28 weeks' gestation and again within 72 hours after delivery. RhoGAM, which stands for Rh immune globulin, aids in the prevention of Rh antibodies development in the Rh-negative individual, which is crucial for the well-being of the fetus. Since the introduction of RhoGAM, the incidence of hemolytic disease of the newborn (HDN) has dropped significantly, from about 13-14% to 0.1% in the United States.
RhoGAM antibodies act by destroying any fetal Rh-positive erythrocytes that may cross the placental barrier, effectively preventing these cells from activating the primary immune response in the Rh-negative individual. This preventive treatment is of utmost importance, especially if the person has had or might have pregnancy events such as amniocentesis, chorionic villus sampling, or abdominal trauma, that could lead to transplacental hemorrhage, in which additional doses of RhoGAM may be necessary.
By following these guidelines, the risk of HDN in subsequent pregnancies is minimized. It's crucial that the client understands the importance of timely administration to ensure the most effective possible prevention of the condition.