The outcomes of 43 pregnancies complicated by the presence of Rhesus antibodies were studied in relation to the peak concentrations of anti-D reached during pregnancy. Antibody concentration was measured by an automated method calibrated against the British Anti-D Working Standard. Where the anti-D concentration remained below 5 IU/ml, the infants at worst suffered only moderate jaundice controllable with phototherapy. Above this level the incidence of requirement for exchange or top-up transfusion was high with concentrations greater than 50 IU/ml being predictive of a very severely affected fetus. It is recommended that amniocentesis in these patients be deferred until maternal anti-D levels exceed 5 IU/ml.
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