Hello Thanks for your query. A positive Indirect coombs test, means that your wife , who is B negative, has developed antibodies already to the baby s blood, which is B positive. Also, it is very rare for this to happen in the first pregnancy itself, unless there were prior miscarriages, or some bleeding or intervention in this current pregnancy. It is more common in the second and subsequent pregnancies, as some amount of blood passes from previous baby/ miscarriage to the mother s circulation, causing the antibodies. When these antibodies are present in the mother s blood, they have a chance of crossing the placenta ,and reaching the baby, and then causing destruction of the Positive group blood cells which baby has. Thus, the baby is at risk of anemia, jaundice, swelling, sudden intra uterine death etc and other complications. Right now, you can take the following steps Be in regular follow up with your obstetrician Keep getting the Indirect Coombs test done at regular intervals as advised. At the critical titre ( critical level ), she might ask you to go for assessment of the baby s condition by drawing blood from the umbilical cord, and then maybe a transfusion to the baby if the condition is severe. Meanwhile, you should be mentally prepared, that with such a condition in early pregnancy, there is definitely increased risk to the baby, particularly with rapidly increasing titres. Also, she should be given Anti D injection within 72 hours of delivery of the baby.