Hemolytic disease of the fetus and newborn due to multiple alloantibodies in pregnancy

Abstract

Immune hemolytic disease of the fetus and newborn is a condition in which there is the premature destruction of fetal or neonatal red cells due to maternal alloantibody against red cell antigen inherited from father. We report the case of Hemolytic disease of fetus and newborn (HDFN) due to anti-E and anti-Fya antibody. Blood grouping was done using the conventional tube technique. Rh and Kell phenotyping of the patient and her husband performed by column agglutination and Duffy phenotyping were done by the conventional tube technique. Direct antiglobulin test was performed by column agglutination technique. Antibody screening and identification were done. Anti-E and Anti-Fya were identified with titer of Anti-E: 1:64 and Anti-Fy a : 1:256. The patient's neonate developed jaundice. Phototherapy was given. Bilirubin stabilized and discharged on the 12 th day.

Haemolytic of Newborn Disease-Related Red Blood Cell Alloantibodies

“…Furthermore, RBCs destruction begins in intrauterine life (12), which causes severe anaemia and neonatal jaundice or even extreme consequences, such as severe brain damage (13). According to , 50% of all foetuses with various aetiologies of HDN died of kernicterus or hydrop foetalis before 1945 (14). The lifespan of the infants' RBCs was shortened as a reaction of maternally cross foreign antibodies being transferred via the placenta and directed against paternally inherited antigens on the RBC.…”

“…In Malaysia, statistics have shown that anti-E is the second most common clinically significant antibody (37) in terms of HDN. The development of anti-E alloantibody can be frequently seen in pregnancies and is associated with HDN with mild to moderate progression (14).…”