"...I do not know of any information that suggests that Rhogam is associated with the development of preeclampsia or HELLP..."

Question: I had HELLP in my 3rd pregnancy, which raised quite a few eyebrows at the time, because I hadn't had any problems in my first two, and I was only in my early 30's.  The general feeling at the time was that HELLP was a by-product of preeclampsia that had somehow gone even further awry. I understand that some scientists now believe that the opposite is true and that HELLP is its own disorder, and in fact leads to its patients

developing preeclampsia.  I know that in my own case, this certainly seems true, as I had no signs of preeclampsia before the day that my HELLP chest pains began.

Like many HELLP patients, I often replay the events of the two days that I spent in the hospital, leading up to my baby's delivery.  And in doing that recently, I remembered a strange thing that happened.  I had to be given a RhoGam shot, because they said no antibodies, real or synthetic, were apparent in my blood tests.  And on top of everything else that they were expecting to go wrong, the last thing that they needed was an RH sensitivity if this baby happened to be RH-positive.  I thought they were crazy, because I knew I had gone in for my RhoGam shot six weeks earlier.  I had the card in my purse.  But somehow all those antibodies were gone!

So as I was contemplating this the other day, a thought hit me.  Do the synthetic antibodies in the shot attach to the red blood cells, like the real RH-antibodies do?  And if this is the case, did my hemolysis destroy those antibodies?  Then an even worse thought struck me.  I'd had those RhoGam shots in both of my other pregnancies.  Is it possible that for some women, instead of acting as a barrier to prevent the body from attacking the next child, the immune system is in fact, recognizing those antibodies and preparing for them?  Could my immune system have placed a deliberate attack on those antibodies, leading to Hemolytic Anemia, and then the systematic shutdown of HELLP Syndrome?

In looking for help on this, I found an article that stated that O- women are more likely than any other group to have HELLP.  I know that your group is in touch with many research organizations and scientists.  And I know that you are participating in many ongoing studies.  I'm wondering if any of those are including RH factor as a consideration for a cause.  I'm not an alarmist, and I don't want women to stop taking RhoGam.  But if there's something that needs to be looked into with it, some small group of us that shouldn't take it, or need to take some sort of alternative to it, the scientific community needs to look into it.

Answer:

The Rh antibodies in the Rhogam should not attach to your red blood cells since they're Rh (-). Even if an Rh (+) woman receives a Rhogam shot, there is not a significant amount of hemolysis.
 
Since the antibodies were gone, you probably had a transfer of some fetal blood into your circulation which the antibodies attached to and destroyed. This could represent a damaged placenta and could be related to the development of preeclampsia and/or HELLP.
 
I do not know of any information that suggests that Rhogam is associated with the development of preeclampsia or HELLP.