Vbr

Surgical correction (Kasai procedure)

Liver transplant if indicated

immune antibody is detected in the mother's serum, proper management includes the following:

1. Obtain past obstetric history and outcome of previous pregnancies.

2. Determine blood group and conduct indirect Coombs' test (to determine the presence and titer of irregular antibodies). Most irregular antibodies can cause initial visit: titer on all patients

Titer-Negative Titer-Positive

Repeat titer on Rh negative at 27-28th week Give Rhogam only to anti-D negative patients

Poor <28-30th week (stillbirths, severe hydrops) Start titers at 20th week

Past Obstetric History

"1

Not poor if titer >1:8

Titer <1:64

Titer >1:64

PUBS* 20-22nd week

Depending on results

Repeat PUBS* amniocentesis1" (after about 10-14 days)

"1 iuivt

Repeat titer

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