The antibody screening program for D negative mother and the anti-D immunoglobulin treatment showed a significant reduction of the occurrence of HDFN secondary to anti-D. in a timely manner and reduce the morbidities and mortalities of HDFN among the newborns. Keywords: Hemolytic Disease of Newborn, Infant, Newborn, RHO(D) antibody, Blood Group Antigens, Phototherapy Catechin Introduction Hemolytic disease of the fetus and newborn (HDFN) occurs due to the presence of red blood cell (RBC) alloantibodies in Ocln the maternal plasma during pregnancy. Those antibodies cross crosses the placental barrier and enters the fetal bloodstream, binds to erythrocyte antigens, and destroy fetal erythrocytes.1,2 Immunoglobulins G (IgG) is actively transported across the placenta and directed against fetal RBCs antigens inherited from the father.1 Passive blood group antibodies from your mother can continue to affect neonatal reddish cells after delivery, causing ongoing anemia until the antibody is no longer present, which can be weeks to months after birth.1,2 Maternal alloimmunization resulted from exposure to foreign RBCs.3 It happens through previous or current pregnancy, previous transfusions, or through an organ transplant.4,5 In fetomaternal hemorrhage (FMH), there is spontaneous mixing between Catechin fetal and maternal blood circulation. The mixing happens throughout the pregnancy and raises by 3%, 12%, and 45% in the 1st, second, and third trimesters, respectively. HDFN due to RBC alloantibodies, especially minor blood groups, rarely happens in the 1st stage of pregnancy because the risk of FMH is usually at the later on stages, especially during delivery. These antibodies tend to develop after delivery.1 Case Statement An infant woman was born to a 25-year-old female at 39 weeks gestation. The baby weighed 2.5 kg and had an Apgar score of 9/10. The baby was mentioned to have jaundice on day time one having a serum bilirubin level of 290 mmol/L. There was a drop in hemoglobin within one day from 20.3 g/dL to 17.0 g/dL with a high reticulocyte count (9.3%) recorded. There was no other cause to suggest neonatal jaundice, such as intrauterine infections and glucose-6-phosphate dehydrogenase deficiency. An urgent peripheral blood film was sent and showed hemolysis with several spherocytes and the presence of nucleated RBCs and polychromasia. The babys blood group was B rhesus (RhD) positive. Direct Coombs test was positive with IgG specificity. Red cell elution studies of infant blood recognized the presence of anti-E and anti-Jka antibodies. Her reddish cells phenotyping showed DCEce (R1R2) Jka+Jkb-, which was similar to the father. Antenatally, the mother experienced a Catechin threatened miscarriage at 13 weeks. She was discharged well without any complications or requiring any blood transfusion. Her blood group was B Rh-positive, and her antibody screening at that time was bad. The pregnancy progressed well without any complications. Post-delivery, her hemoglobin level was 12.0 g/dL with positive antibody screening. In the postnatal period, antibody recognition was carried out and alloantibodies to Jka and E antigen were found. The mothers RBC phenotyping was Jka-Jkb+ and E-e+. Maternal anti-E and the anti-Jka antibody titer were identified as 1:512 and 1:32, respectively. Intravenous immunoglobulin and rigorous phototherapy were started for the baby since bilirubin levels were increasing. Simultaneously, we requested new whole blood with both antigens bad (E and Jka) in anticipation for a possible need for an exchange transfusion from your blood bank. The possibilities for anti E or anti-Jka to cause severe jaundice is definitely rare, but based on one case statement, the chances to develop severe HDFN cannot be overlooked. HDFN due to anti-Jka is rare and can cause prolonged anemia in the infant.6 Fortunately, the babys two-hourly serum bilirubin level showed a decreasing pattern, and she did not require exchange transfusion and was discharged well on day time nine. The daily blood investigations are demonstrated in Table 1. Table Catechin 1 Serial hemoglobin level, reticulocyte count, and liver function test.
Full blood countHemoglobin, g/dL20.317.716.112.411.912.6Reticulocyte, %9.29.49.910.79.16.6Liver function testTotal bilirubin, mol/L290294280289216163Indirect bilirubin, mol/L279281270278205152Direct bilirubin, mol/L111310111111 Open in a separate window Conversation This case illustrates an uncommon example of HDFN caused by anti-E and anti-Jka alloantibodies. The antibodies were identified from your reddish cell eluate of the baby and the mothers serum postnatally. In this case, there was no antibody recognized antenatally before 13 weeks gestation, and there was no subsequent.