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Rh antibody titers every four weeksFrom: D. G. Huffman (perinatl@slip.net)Mon Sep 23 01:22:49 1996
"Rh antibody titers every four weeks" Perhaps this will clear up the issue somewhat. My apologies to ACOG for any copyright violation, although this probably comes under the "fair use" doctrine. The entire text of the ACOG bulliten in question can be obtained from ACOG Educational Bulletin Number 227, August 1996, [Replaces Number 148, October 1990]. You are encouraged to obtain the document in its entirety and read the whole thing. For members of ACOG, the text can be obtained online over the internet from ACOG. Go to http://www.acog.com/ and then go to "member access". (Register first, if you have not done so previously.) Then select the "ACOG Technical Bulletins" box, and enter "Bulletin Number 227" in the appropriate box and this bulliten will come up on the screen. Non members of ACOG often can obtain the bulletin in local medical libraries, from local members of ACOG, or from ACOG itself. Note also that the bulliten has a standard disclaimer at the end. The text is: Once it has been established that a pregnant woman is sensitized to an antigen that may cause erythroblastosis ... [about three paragraphs removed here] ... [and i]f a patient has never had a pregnancy complicated by Rh-related neonatal morbidity other than hyperbilirubinemia treated by phototherapy, antibody titers are the initial step of management. An antibody titer should be determined at the first prenatal visit, at 20 weeks of gestation, and approximately every 4 weeks thereafter. When the antibody titer is 1:8, whether directed to D or another paternal antigen capable of causing severe erythroblastosis, no intervention is necessary; when the titer is 1:16 in albumin or 1:32 by indirect antiglobulin (indirect Coombs test), amniocentesis or percutaneous umbilical cord blood sampling (cordocentesis) should be considered (5). ... I hasten to add: Copyright August 1996 ISSN 1074-8628 The American College of Obstetricians and Gynecologists 409 12th Street, SW PO Box 96920 Washington, DC 20090-6920 12345/09876 This Educational Bulletin was developed under the direction of the Committee on Educational Bulletins of the American College of Obstetricians and Gynecologists as an aid to obstetricians and gynecologists. The College wishes to thank Michael L. Socol, MD, for his assistance in the development of this bulletin. This document is not to be construed as establishing a standard of practice or dictating an exclusive course of treatment. Rather, it is intended as an educational tool that presents current information on obstetric-gynecologic issues. Dean Huffman
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