📌According to Berghella and Williams Obstetrics
· Most laboratories consider 16 as the critical antibody titer for Rh(D) and non-Rh(D) alloimmunized pregnancies, except for Kell-immunized pregnancies in which case 4 is considered the critical titer.
· If alloimmunization is detected and the titer is below the critical value, the titer is generally repeated every 4 weeks for the duration of the pregnancy (American College of Obstetricians and Gynecologists, 2016).
· In any pregnancy in which an antibody titer has reached a critical value, there is no beneit to repeating it. The pregnancy is at risk even if the titer drops, and further evaluation is still required.
· The middle cerebral artery peak systolic velocity (MCA- PSV) performs well as a screening tool for severe fetal anemia of any etiology and it is associated with a reduction in the number of invasive tests. Screening with MCA- PSV can be started as early as 15 weeks. If the MCA-PSV is ≥1.5 multiples of the median (MoM), fetal blood sampling (FBS) is indicated. Blood transfusions should be ini- tiated for fetal hemoglobin <5th percentile, 2SD below the mean for gestational age or HTC <30%.
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