Rh-D-primigravida mother with anti Rh-17 antibodies causing mild haemolytic disease of foetus and newborn in baby: a case report
Rh-D- is an unusual phenotype in Rh blood group system, lacking all Cc or Ee antigens but demonstrates a stronger D antigen expression. We describe here an extremely rare Rh-D phenotyped mother with first baby affected by haemolytic disease of foetus and newborn (HDFN). A 20-year-old pregnant lady, presented in active labour with foetal distress and planned for emergency cesarean section. Her blood group was A RhD positive, with positive antibody screening. Antibody identification demonstrated multiple antibodies against RhCc Ee polypeptide by the reference laboratory. Rh phenotype was -D-/-D- with no C/c and E/e antigen but strong D antigen. Crossmatch was incompatible with all A RhD positive units. Management of such patient is extremely difficult due to the scarcity of Rh-D- donor blood. In this case, reference laboratory had one frozen Rh-D- blood ready for use if indicated. Fortunately, patient underwent caesarean section without any complication. Baby was grouped as A Rh-D positive with probable Rh genotype as CDe/-D-. Baby’s DCT was positive and eluate showed antibodies of identical reactivity as mother. Baby developed mild jaundice at day-2 and managed with phototherapy. Clinically Rh-D- phenotype in pregnant women can cause mild to fatal HDFN. Routine antibody screening in pregnant women can detect such rare case that helps proper management of mother and baby. Prior arrangement of this rare blood is warranted to prevent the maternal and infant mortality and morbidity.
Bangladesh Journal of Medical Science Vol.20(3) 2021 p.669-672
Copyright (c) 2021 Rabeya Yousuf, Nor Fadzliana Abdullah Thalith, Yee Loong Tang, Chooi Fun Leong
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors who publish in the Bangladesh Journal of Medical Science agree to the following terms that:
- Authors retain copyright and grant Bangladesh Journal of Medical Science the right of first publication of the work.
Articles in Bangladesh Journal of Medical Science are licensed under a Creative Commons Attribution 4.0 International License CC BY-4.0.This license permits use, distribution and reproduction in any medium, provided the original work is properly cited.
- Authors are able to enter into separate, additional contractual arrangements for the distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
- Authors are permitted to post their work online (e.g., in institutional repositories or on their website) as it can lead to productive exchanges, as well as greater citation of published work.