ACOG practice bulletin. Prevention of Rh D alloimmunization. Number 4, May 1999 (replaces educational bulletin Number 147, October 1990). Clinical management guidelines for obstetrician-gynecologists. American College of Obstetrics and Gynecology.

The reduction in the incidence of Rh D alloimmunization is a prototype for the effectiveness of preventive medicine. Some controversies remain, however, such as the use of anti-D immune globulin in patients with either threatened abortion or antenatal hemorrhage. Similarly, it may not be cost-effective either to screen all Rh D-negative patients with an indirect Coombs test at 24-28 weeks of gestation or to screen all postpartum patients for excessive fetomaternal hemorrhage.