Repeated severe neonatal hemolysis due to Rhesus isoimmunization in a pregnant woman.

Abstract

Rhesus (Rh) isoimmunization presenting as severe neonatal hemolytic disease is rare in RhD negative primigravidas of Chinese ethnicity. We report the case of a 32-year-old pregnant Taiwanese woman, RhD negative, who gave birth vaginally to two RhD-positive full-term fetuses 6 years apart. Antenatal follow-up was uneventful and there was no obvious fetal-maternal hemorrhage except at the performance of amniocentesis at the 19th week of the first pregnancy without anti-D immune globulin prophylaxis. Although anti-D immune globulins were administered to the mother within 1 hour after each birth, both of the newborns had severe neonatal hemolysis refractory to phototherapy and were rescued by exchange transfusions. Both of the children were well at age 7-years-old and one-year-old respectively In conclusion, with suspicion of fetal-maternal hemorrhage in RhD-negative pregnancies post amniocentesis, serial monitoring of indirect Coombs titer with appropriate management is mandatory.

• Authors: Da-Chung Chen, Yeing-Kuan Chang, Wei-Hwa Chen, Jah-Yao Liu
• Journal: Journal of the Formosan Medical Association = Taiwan yi zhi (J Formos Med Assoc) Vol. 101 Issue 5 Pg. 359-61 (May 2002) ISSN: 0929-6646 [Print] Singapore
• PMID: 12101855 (Publication Type: Journal Article)

Chemical References

• Isoantibodies
• Oncogene Proteins, Fusion
• RHO(D) antibody
• Recombinant Fusion Proteins
• Rh-Hr Blood-Group System
• RhD fusion protein, human
• Rho(D) Immune Globulin
• Rho(D) antigen

Topics

• Adult
• Female
• Hemolysis
• Humans
• Isoantibodies (therapeutic use)
• Oncogene Proteins, Fusion
• Pregnancy
• Recombinant Fusion Proteins
• Rh Isoimmunization (complications)
• Rh-Hr Blood-Group System
• Rho(D) Immune Globulin