"Vaccinating" Against Rh

If a woman with Rh-negative blood bears a baby fathered by an Rh-positive man, there is a grave risk that she will become sensitized to the Rh factor in her baby's blood and begin to produce anti-Rh antibody. The process is not likely to affect the first baby, but in subsequent pregnancies the mother may make so much of the antibody that her own blood will destroy most of her child's red blood cells and threaten its life. When that happens, massive transfusions, often involving complete replacement of the baby's blood immediately after birth, are the only cure.

On the theory that an ounce of prevention would be far preferable, a group of obstetricians and hematologists at Columbia University began to search for a substance with which to vaccinate an Rh-negative woman so that she would never become sensitized. It took two years, Dr. Vincent J. Freda told the American College of Obstetricians and Gynecologists last week, for him and Dr. John Gorman to get just the right blood fraction they wanted -- a special gamma globulin rich in Rh antibody. They proved its safety and potency by injecting it into Sing Sing prison volunteers -- all men.

For a year and a half, the Columbia-Presbyterian Medical Center researchers have been injecting the special gamma globulin into Rh-negative women who have had one child. By now the doctors have vaccinated 35 women who have been studied for about six months and have not yet become sensitized. Once a woman is sensitized, the doctors emphasize, it is too late;vaccination offers no hope for a woman who has already borne a baby showing blood-destruction problems. Though one case is no proof, it is encouraging that a woman in the study group who was heading for Rh problems had twins last week with no sign of blood destruction.

Researchers in Liverpool, England, got the idea of vaccination at almost the same time and are conducting a similar experiment. Now, like the New York group, they are waiting to learn whether vaccination against Rh problems really works.

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