Dr. Stiehm's review article in Pediatrics (63:301, 1979) is excellent in its comprehensive treatment of the use of immune serum globulin. However, the portion on Rh immune globulin (RhIG) has two omissions regarding current management of the Rh-negative woman: (1) Amniocentesis is an indication for considering the use of RhIG in the Rh-negative pregnant woman, and (2) evidence of massive fetal-maternal hemorrhage (placenta abruptio, placenta previa, or neonatal anemia) in the Rh-negative woman should be cause for an attempt to determine the magnitude of that bleed and gauge the dose of RhIG to the volume of that bleed.

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