Fatal hydrops fetalis caused by anti-D in a mother with partial D.

Abstract

BACKGROUND:

Rare cases of hemolytic disease of the newborn occur in women with genetic variants of the D antigen. A partial D variant might be suspected when typing for the D antigen shows weaker-than-normal reactions (weak D). Historically, patients with a weak D phenotype have not been considered candidates for Rh immune globulin prophylaxis.

CASE:

A gravida 2, para 1 woman with A-positive blood type, delivered an infant who died from severe hemolytic disease of the newborn 6 days after birth. Anti-D, undetectable at the first prenatal visit, was identified (titer 1:64) at delivery. The mother's red cells were partial D(VI) phenotype.

CONCLUSION:

Although severe hemolytic disease in patients with partial D is rare, this neonatal death illustrates the need for a change in management of women with weak D.

• Authors: Michael Cannon, Richard Pierce, Evan Beth Taber, Jodi Schucker
• Journal: Obstetrics and gynecology (Obstet Gynecol) Vol. 102 Issue 5 Pt 2 Pg. 1143-5 (Nov 2003) ISSN: 0029-7844 [Print] United States
• PMID: 14607035 (Publication Type: Case Reports, Journal Article)

Chemical References

• Isoantibodies
• Rh-Hr Blood-Group System

Topics

• Adult
• Erythroblastosis, Fetal (etiology)
• Fatal Outcome
• Female
• Humans
• Hydrops Fetalis (etiology)
• Isoantibodies (immunology)
• Pregnancy
• Rh-Hr Blood-Group System (immunology)