Severe anti-D haemolytic disease of fetal and newborn in rhesus D negative primigravida
- Author:
Mohd Nazri Hassan
1
Author Information
1. Department of Haematology, School of Medical Sciences, Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan
- Collective Name:Mohd Nazri Hassan; Salfarina Iberahim; Wan Suriana Wan ABDUL Rahman; Zefarina Zulkafli; Rosnah Bahar; Marini Ramli; Noor Haslina Mohd Noor; Rapiaah Mustaffa
- Publication Type:Case Reports
- Keywords:
Anti-D;
HDFN;
RhD negative;
primigravida
- MeSH:
primigravida
- From:The Malaysian Journal of Pathology
2019;41(1):55-58
- CountryMalaysia
- Language:English
-
Abstract:
Introduction: Anti-D alloimmunisation may occur from the blood transfusion or fetomaternal haemorrhage which can lead to haemolytic disease of fetal and newborn (HDFN). The morbidity and mortality of HDFN related to anti-D is significantly reduced after introduction of anti-D prophylaxis and furthermore, anti-D HDFN in RhD negative primigravida is uncommonly seen. Case Report: A case of unusual severe HDFN due to anti-D alloimmunisation in undiagnosed RhD negative primigravida Malay woman is reported here. This case illustrates the possibility of an anamnestic response from previous unknown sensitisation event or the development of anti-D in mid trimester. The newborn expired due to hydrops fetalis and severe anaemia. Antenatally, the mother was identified as RhD positive and thus there was no antenatal antibody screening, antepartum anti-D prophylaxis or close fetal monitoring for HDFN. Discussion: The thorough antenatal ABO and RhD blood grouping with antibody screening is mandatory as part of prevention and early detection of HDFN especially due to anti-D alloimmunisation. Improper management of RhD negative women might lead to severe HDFN including in primigravida.
- Full text:5.2019my0993.pdf
