Rh sensitized

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I am 28w3d pregnant with my second child, and have somehow become Rh sensitized...we have no idea how, since I had no antibodies with my first pregnancy, and haven't had any exposure to Rh+ blood, miscarriages, etc since...but that's a moot point since it's done. My blood type is A- and my husband's is O+. My existing child is A+. I have been seeing a perinatologist since I was 13 weeks pregnant, having been diagnosed with high antibody titers at my first (9 week) prenatal visit. We have been monitoring the baby's condition ever since with ultrasounds, and recently, amniocentisis. I have had 2 amnios to test for billirubin so far, and I go for my 3rd on Tuesday. The results of my last amnio were at the same level as my first 3 weeks prior, but my peri says that because I am farther along, it puts me in a higher zone. The repeat amnio will be 2 weeks after the previous. Currently, I am in the lower end of Zone 2 for billirubin levels in my amniotic fluid. My last antibody titer was about 2 months ago, and the levels of anti-D were 1:256. So far, there are no signs of hemolytic disease visible to the ultrasound.

After this long history...my questions are:

1) Is is possible for the billirubin levels in the amniotic fluid to decrease at this point? For example, could I go back into Zone 1?

2) Assuming that the levels don't go past Zone 2, and don't decrease into Zone 1, what is the standard treatment? Does the OB induce delivery early?

3) Are there any questions or concerns that I should be bringing up with my perinatologist about the treatment? The amnios started at 24 weeks, and I have a feeling that they will continue roughly every 2 weeks until I deliver. I understand that we have to wait for the results of the next test to determine what the course of action is, but I am interested in the basic treatment at this point.

My peri doesn't think that this pregnancy will go to the point of needing intrauterine blood transfusions. Will the baby need blood transfusions after birth?

Thanks in advance for your answers!

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