Singla Shilpa, Kumar Sunesh, Roy Kallol Kumar, Sharma Jai Bhagwan, Kachhawa Garima
Department of Obstetrics and Gynecology, All India Institute of Medical Sciences, New Delhi, 110029, India.
J Med Case Rep. 2010 Feb 18;4:57. doi: 10.1186/1752-1947-4-57.
Rhesus haemolytic disease of the newborn is a prototype of maternal isoimmunisation and fetal haemolytic disease. There are other rare blood group antigens capable of causing alloimmunisation and haemolytic disease such as c, C, E, Kell and Duffy. In India, after the confirmation of a newborn's blood group, antibodies are screened only if the mother is Rehsus D-negative negative and the father is Rhesus D-positive. Hydrops in Rhesus positive women are investigated along the lines of non-immune hydrops.
We report the case of a patient from India where irregular antibodies were requested for an O-positive 26-year-old mother in order to investigate fetal hydrops. Anti-c antibody was revealed and the fetus was treated successfully with compatible O negative and c negative intrauterine blood transfusions. The baby was treated postnatally with double volume exchange transfusion with the same compatible blood, and was discharged 30 days after birth.
We highlight the importance of conducting irregular antibody screening for women with significant obstetric history and fetal hydrops. This could assist in diagnosing and successfully treating the fetus with appropriate antigen negative cross-matched compatible blood. We note, however, that anti-c immunoglobulin is not yet readily available.
新生儿恒河猴溶血病是母体同种免疫和胎儿溶血病的典型代表。还有其他一些罕见的血型抗原能够引起同种免疫和溶血病,如c、C、E、凯尔(Kell)和达菲(Duffy)血型抗原。在印度,确认新生儿血型后,仅当母亲为恒河猴D阴性且父亲为恒河猴D阳性时才进行抗体筛查。恒河猴阳性女性的水肿按照非免疫性水肿的方式进行检查。
我们报告一例来自印度的病例,一名26岁O型阳性母亲因胎儿水肿接受不规则抗体检测。检测发现了抗c抗体,胎儿通过输注相容的O型阴性且c阴性的宫内输血成功接受治疗。婴儿出生后接受了相同相容血液的双倍量换血输血治疗,并于出生后30天出院。
我们强调了对有重要产科病史和胎儿水肿的女性进行不规则抗体筛查的重要性。这有助于用适当的抗原阴性交叉配型相容血液诊断并成功治疗胎儿。然而,我们注意到抗c免疫球蛋白目前尚不易获得。