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Recurrent fetal hydrops with maternal M alloimmunisation: not a benign condition
  1. Michelle Yu1,
  2. Kathryn Graham1,
  3. Leonardo Pasalic2 and
  4. Thushari Indika Alahakoon3
  1. 1 Department of Obstetrics & Gynaecology, Westmead Hospital, Westmead, New South Wales, Australia
  2. 2 Department of Haematology, Westmead Hospital, Westmead, New South Wales, Australia
  3. 3 Westmead Institute for Maternal and Fetal Medicine, Westmead Hospital, Westmead, New South Wales, Australia
  1. Correspondence to Dr Michelle Yu, michelleyu.myu{at}


Haemolytic disease of the fetus and newborn (HDFN) is associated with red cell antibodies. Anti-M usually results in a mild haemolysis and is rarely clinically significant. There is no established consensus on management of pregnancies with anti-M. A case of recurrent HDFN with maternal M alloimmunisation was identified at a tertiary hospital in Australia. We collected the patient and neonate’s clinical and pathological data and interpreted the case with available literature. This is the first case in literature of recurrent fetal hydrops in the setting of M alloimmunisation. Neonate was delivered in a poor condition, intubated and admitted to the neonatal intensive care unit for ionotropic support, red cell transfusion and plasma transfusion for coagulopathy. Direct Coombs test was positive, confirming HDFN. Although anti-M rarely causes HDFN, accurate history, fetal surveillance and monitoring is essential for identification of fetal anaemia. Concurrent placental disease may increase fetal risk from anti-M antibodies.

  • haematology (incl blood transfusion)
  • pregnancy
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  • Contributors MY: project development, manuscript writing and editing. KG: ultrasound images. LP: manuscript editing. TIA: project development, manuscript writing and editing.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Patient consent for publication Obtained.

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