A case involving an O-negative mother whose pregnancy was complicated with hemolytic disease of the fetus and newborn (HDFN) due to ABO alloimmunization has been recently published in the Asian Journal of Transfusion Science.
“HDFN primarily results from ABO and Rh antibodies,” the authors wrote.” However, it is crucial to recognize minor blood group incompatibilities such as Kell, Kidd (Jk), MNS, and Duffy (Fy), which may also cause significant hemolysis in the baby’s red cells.”
HDFN arises from blood group incompatibility between the fetus and mother. In cases where the fetus has a red blood cell (RBC) antigen absent in the mother, the mother can produce antibodies targeting that antigen in a process known as alloimmunization.
Learn more about HDFN causes and risk factors
The case involved an O-negative woman with a history of beta thalassemia, a form of anemia. During her first pregnancy, she suffered premature membrane rupture and was admitted for a cesarean section at 24 weeks of gestational age.
The premature baby had a B-positive blood group and developed severe anemia and yellowish coloration of the skin (jaundice) within the first 24 hours after birth. She received blood transfusions that same day.
Laboratory workup on both the mother and the baby revealed the presence of anti-Jka antibodies as well as anti-B antibodies. Although the presence of anti-B antibodies had been detected during prenatal care, the presence of anti-Jk antibodies was surprising. The results raised the question of whether the patient’s HDFN was due to B or Jk alloimmunization.
The physicians prepared double volume exchange transfusions (DVET) with O positive, Jk negative red blood cells and AB positive plasma. The patient responded well to treatment.
“Routine antibody screening is recommended for antenatal females, as it can indicate the potential for minor blood group antigen incompatibility between the mother and baby…considering anti‐A and anti‐B titers in O‐positive mothers is valuable for predicting the likelihood of ABO HDFN,” the authors wrote.
