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May 5, 1962

Rh Factors and Pregnancy

JAMA. 1962;180(5):429. doi:10.1001/jama.1962.03050180075024

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To the Editor:—  The father is A Rh-positive. The mother is O Rh-negative, healthy, in her mid-20's, has had one previous, uncomplicated pregnancy, of which the child, now 2 years old, is healthy. There have been no previous blood transfusions, miscarriages, etc. The present (second) pregnancy, now in the eighth month of gestation, has been uncomplicated. Rh antibody titer, first reading, now is 1:4.Should this pregnancy be allowed to go to full term and exchange transfusions instituted for the baby then, if necessary, or is an early vaginal delivery indicated, possibly with exchange transfusions? Is there not a greater danger of kernicterus and mental deficiencies in an early delivery, despite exchange transfusions, since the liver of a premature baby cannot handle bilirubin well?Is it better to risk a full-term gestation (with a very slim chance of a stillbirth) than to risk the early delivery of a premature baby,