Laboratorydiagnosis and perinatal blood management of HDFN in a Jr(a-) pregnant woman
10.13303/j.cjbt.issn.1004-549x.2026.02.013
- VernacularTitle:1例Jr（a-）孕妇的HDFN实验室诊断与围产期血液管理
- Author:
Pan XIAO
1
;
Ke SONG
1
;
Wei YANG
1
;
Lingling LI
1
;
Yi LIU
1
;
Chunya MA
1
;
Yang YU
1
Author Information
1. Department of Transfusion Medicine, First Medical Center, PLA General Hospital, Beijing 100853, China
- Publication Type:Journal Article
- Keywords:
Jra antigen;
anti-Jra antibody;
autologous blood;
hemolytic disease of fetus and newborn
- From:
Chinese Journal of Blood Transfusion
2026;39(2):248-255
- CountryChina
- Language:Chinese
-
Abstract:
Objective: To report the antibody identification, blood management during pregnancy and the monitoring process of fetal hemolytic disease of fetus and newborn (HDFN) in a pregnant woman with a history of blood transfusion and pregnancy who developed anti-Jr
. Methods: Saline tube technique and anti-human globulin technique were used for maternal blood typing, unexpected antibody screening and identification, as well as for determining antibody titer and IgG subclasses. PCR-SSP was employed for genotyping of 18 blood group systems. Next-generation sequencing (NGS) was utilized for gene sequencing of 38 blood group systems. Sanger sequencing was applied to verify rare blood group mutations detected by NGS and to investigate the corresponding rare blood group genes in family members. Blood preparation was achieved through anemia management in prenatal clinics and autologous blood collection during pregnancy. The newborn underwent the three primary tests for HDFN and plasma IgG subclass testing. Results: The pregnant woman's blood type was B, RhD positive, with a positive unexpected antibody screen, and the antibody identification pattern was consistent with a high-frequency antigen antibody. Gene sequencing revealed a homozygous ABCG2 c.376C>T mutation in the woman, resulting in the Jr(a-) phenotype, and anti-Jr
antibody was present in her plasma. No compatible Jr(a-) blood was found among family members. The maternal anti-Jr
IgG titer remained stable at 256 during pregnancy, with no detectable IgG1 or IgG3 subclasses against the Jr
antigen. A total of 800 mL of autologous blood was collected in two stages during pregnancy. The newborn was B, RhD positive, Jr(a+), with a positive unexpected antibody screen (anti-Jr
). IgG subclass typing detected no IgG1 or IgG3. The direct antiglobulin test was positive, while the acid elution test was negative. Conclusion: The combination of serology and blood group genetic analysis provides a diagnostic basis for identifying antibodies to high-frequency antigens. Managing perinatal anemia and implementing staged autologous blood storage can secure blood supply for the perioperative period. IgG antibody subclass typing offers a reference for clinical assessment and prevention of HDFN.
