If monitoring shows that the bilirubin levels in the amniotic fluid are normal, no treatment may be needed as the pregnancy proceeds to delivery.
If the levels are high, showing a threat to the fetus, it may be given transfusions inside the uterus every 10 days to two weeks until it has reached the 32nd to 34th weeks of pregnancy. Then a delivery should be done. These procedures must be done at a medical center that can care for high-risk pregnancies.
The baby should be delivered with as little trauma as possible. The placenta should not be removed manually to avoid squeezing cells from the baby's blood into the mother's blood stream. A newborn born with Rh disease should be seen immediately by a pediatrician who can do an exchange transfusion at once if necessary.
Steps can be taken to assure that antibodies aren't made in the first place. This can be done by giving the mother a shot of anti-Rh antibodies within 72 hours of the delivery of the baby. This causes any of the baby's red blood cells that may have crossed into the mother's blood to be destroyed before sensitizing the mother's immune system.
This has to be done with each pregnancy -- normal or ectopic -- whether it ends in a delivery or an abortion.
If there is much blood loss during delivery, additional injections may be needed. Between 1 and 2% of the time this treatment fails. This is apparently because the mother has already become sensitized during pregnancy rather than at delivery.
The treatment can be done preventatively to mothers with Rh-negative blood and no apparent sensitization at about 28 weeks of pregnancy. Any antibodies circulating in the mother's blood are gradually destroyed and the mother remains unsensitized. The treatment should also be given after any bleeding or after amniocentesis or chorionic villus sampling.