Management of the Rh-sensitized mother

The approval by the FDA of Rh immune globulin in 1968 led to a decrease in the incidence of Rh isoimmunization. As a result, fewer cases are seen by both the perinatologist and neonatologist. Prompt identification and early referral of the isoimmunized mother to a tertiary center will facilitate optimal management incorporating the latest techniques. In selected clinical situations, the less invasive technique of amniocentesis can be offered in place of fetal blood sampling for Rh D typing. In the anemic fetus requiring intrauterine transfusions, delivery is the goal once lung maturity is documented. As described elsewhere in the issue, recent improvements in neonatal care have facilitated management of complications not seen in the fetus but potentially critical in the neonate.