Management of isoimmunization in pregnancy. ACOG Technical Bulletin number 148--October 1990.

Isoimmunization is diagnosed by a positive antibody screen and requires identification of the specific antigen responsible, titration of the level of antibody response, and classification of the antigen into either a clinically significant or benign group. The paternal antigen status and zygosity should be determined whenever possible. A significant antibody response to an antigen associated with erythroblastosis should be monitored at regular intervals by obtaining serial titers, and repetitive amniocentesis or fetal blood sampling may be required to adequately monitor the fetal condition. Early and continued consultation with a perinatologist and a neonatologist who are experts in the management of this condition is critical in developing an appropriate therapeutic plan that includes proper management at delivery and optimal neonatal support. New technologies and expertise now allow better outcome for severely affected fetuses.

Patient Criteria & Setting