Successful management of severe hemolytic disease of the fetus due to anti‐<scp>Jsb</scp> using intrauterine transfusions with serial maternal blood donations: a case report and a review of the literature

Riyami, Arwa Z. Al; Salmani, Moza Al; Hashami, Sabria Al; Mahrooqi, Sabah Al; Hinai, Sumaiya Al; Balushi, Halima Al; Riyami, Nihal Al; Gowri, Vaidyanathan; Dughaishi, Tamima Al; Hosni, Saif Al; Al-Khabori, Murtadha; Al-Farsi, Khalil; Huneini, Mohammed Al; Alkindi, Salam

doi:10.1111/trf.12331

Cited by 15 publications

(10 citation statements)

References 14 publications

(22 reference statements)

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“…18 A saline wash was used for the processed RBC units of one previously reported patient with HDFN due to the presence of anti-Js b antibodies; in this case, the mother had donated blood while pregnant due to the low likelihood of finding a suitable donor. 19 All RBC units were quality-checked for final volume measurements, Hct proportion and residual WBC counts. After testing to determine the ABO blood group, the donor samples were additionally screened for Rh (C, c, E and e) and K antigens, the sickle cell trait and glucose-6-phosphate dehydrogenase deficiency.…”

Section: Intrauterine Fetal Blood Transfusionmentioning

confidence: 99%

Intrauterine Fetal Blood Transfusion: Descriptive study of the first four years’ experience in Oman

Al-Riyami

Al-Salmani

Al-Mahrooqi

et al. 2018

Sultan Qaboos Univ Med J

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Section: Intrauterine Fetal Blood Transfusionmentioning

confidence: 99%

Intrauterine Fetal Blood Transfusion: Descriptive study of the first four years’ experience in Oman

Al-Riyami

Al-Salmani

Al-Mahrooqi

et al. 2018

Sultan Qaboos Univ Med J

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“…Where detected, antibodies to other antigens in the Kell blood group system (e.g. anti‐k, ‐Kp a , ‐Kp b , ‐Js a , ‐Js b ) should be investigated and monitored in the same way as anti‐K as these have the potential to cause HDFN (Al Riyami et al, ).…”

Section: Red Cell Antibodies Detected In Pregnancymentioning

confidence: 99%

Guideline for blood grouping and red cell antibody testing in pregnancy

White¹,

Qureshi

Massey

et al. 2016

Transfusion Medicine

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“…However, when multiple maternal blood donations for IUT are needed, it is necessary to advise iron and folic acid supplementation. Serial maternal donations can be successfully managed by recombinant human erythropoietin and intravenous iron [25]. Washed maternal RBCs are safe for fetal transfusion therapy, even when they are ABO incompatible, because the fetus does not have its own anti-A and anti-B antibodies, so maternal RBCs cannot be hemolyzed [15].…”

Section: Discussionmentioning

confidence: 99%

The Outcome of Hemolytic Disease of the Fetus and Newborn Caused by Anti-Rh17 Antibody: Analysis of Three Cases and Review of the Literature

Dajak

Ipavec

Cuk

et al. 2019

Transfus Med Hemother

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Background: Anti-Rh17 is a rare red blood cell (RBC) antibody to high-frequency antigens that may cause severe hemolytic disease of the fetus and newborn (HDFN). Despite the rarity of HDFN caused by Anti-Rh17, this antibody was reported in many different populations. Emergency transfusions, especially exchange transfusions, present a huge problem if no compatible RBCs of phenotype D-- are available. Methods: Here we report obstetrical histories of three women and describe their pregnancies complicated by anti-Rh17 antibodies. We summarized published cases of pregnancies complicated by anti-Rh17 and reviewed transfusion treatment and outcomes. Additionally, a simplified flowchart for the management of such pregnancies is proposed. Results: Four pregnancies were affected by severe HDFN, and three of them ended with perinatal death. In the fourth case, the baby was born hydropic and icteric and the condition was rapidly deteriorating. Emergency exchange transfusion was performed with incompatible O-negative RBC units in AB-negative plasma. The baby was discharged on the 14th day in good health. In the available literature, 15 women and 22 pregnancies were reported, 20 of them developed severe HDFN. According to the data, intrauterine transfusion for treatment of HDFN was the most common form of treatment with the donation of the mother’s blood. Different options for exchange transfusion were described, including incompatible RBCs. Conclusion: In more than 90% of described pregnancies of HDFN caused by anti-Rh17 antibody, transfusion treatment was required. Therefore, RBC from D-- phenotype has to be available. According to published data, in emergent circumstances when maternal and blood from donor with phenotype D-- is not available, incompatible exchange transfusion is a better choice than delaying transfusion when it is necessary. It is of essential importance that pregnancies with high risk of HDFN due to anti-Rh17 are managed by a multidisciplinary team (transfusion medicine specialist, obstetrician, neonatologist) in a highly specialized tertiary institution.

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Successful management of severe hemolytic disease of the fetus due to anti‐Jsb using intrauterine transfusions with serial maternal blood donations: a case report and a review of the literature

Abstract: This case represents a successful example of managing hemolytic disease of the fetus due to a rare antibody using maternal blood. It also supports previous data on safety of maternal donations during pregnancy and the use of combination of rHu-EPO and IV-Fe as a supportive measure.

Cited by 15 publications

References 14 publications

Intrauterine Fetal Blood Transfusion: Descriptive study of the first four years’ experience in Oman

Intrauterine Fetal Blood Transfusion: Descriptive study of the first four years’ experience in Oman

Guideline for blood grouping and red cell antibody testing in pregnancy

The Outcome of Hemolytic Disease of the Fetus and Newborn Caused by Anti-Rh17 Antibody: Analysis of Three Cases and Review of the Literature

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