title: Changing trends in the management of red blood cell alloimmunization in pregnancy.
abstract: OBJECTIVE
  Review the current management of red blood cell alloimmunization in pregnancy.
  
  
  METHODS
  Retrospective review of the literature and 8-year experience at Baylor College of Medicine, Houston, Tex.
  
  
  RESULTS
  Rhesus alloimmunization continues to affect one in 1000 pregnancies. Newly diagnosed disease can be managed with serial anti-human globulin titers until a critical value is achieved. Thereafter diagnostic modalities include ultrasound, amniocentesis, and percutaneous umbilical blood sampling. Patients with a history of a previously affected pregnancy should be managed in a more aggressive fashion. Newer methods of intravascular intrauterine transfusion can result in neonatal survival in more than 75% of cases. Long-term evaluation of these neonates indicates a good neurologic outcome.
  
  
  CONCLUSIONS
  New approaches to therapy using preimplantation diagnosis or selective suppression of the maternal immune system appear promising for the future.
authors.affiliation: Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, TX 77030.
authors.forename: K J
authors.initials: KJ
authors.lastname: Moise
mesh_terms: D001805:Blood Transfusion, Intrauterine; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D011247:Pregnancy; D012189:Retrospective Studies; D012203:Rh Isoimmunization / Q000453:epidemiology / Q000517:prevention & control / Q000628:therapy*