<prompt> Two weeks later, the results of the patients prenatal labs come back. Her blood type is A, with an anti D antibody titer of 1:4. What is the most appropriate next step in the management of this patient?Schedule an amniocentesis for amniotic fluid bilirubin at 16 weeksRepeat titer in 4 weeksRepeat titer in 28 weeksSchedule PUBS to determine fetal hematocrit at 20 weeks  <response>: In the same patientblood grouping shows A negative, with an anti D antibody titer of 1:4- the most appropriate next stepin the management Since this patient is a primi patient and her antibody titre is 1:4 so we should follow it by doing a repeat titre after every 4 weeks.If this pregnancy would not have been her first affected pregnancy, then amniocentesis i.e. option a would have been the correct response. 