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Case report
Haemolytic disease of the fetus and newborn diagnosed after delivery of a baby to a mother with low anti-E antibody titres
  1. Tara T’Shieh Maey Lee1,
  2. Paul Clarke2 and
  3. Edward Prosser-Snelling1
  1. 1 Maternity Department, Norfolk and Norwich University Hospitals NHS Foundation Trust, Norwich, UK
  2. 2 Neonatal Intensive Care Unit, Norfolk and Norwich University Hospital, Norwich, UK
  1. Correspondence to Dr Tara T’Shieh Maey Lee, taratmlee{at}


The authors report a term male neonate who was born in unexpectedly poor condition with low Apgar scores and low venous cord gas pH. He required admission to the neonatal unit and was found to have developed haemolytic anaemia with associated hydrops, following a presumed severe antenatal insult. Antenatally, low levels of anti-E antibodies (titre 8) had been detected at 28 weeks’ gestation. Following the British Society for Haematology and local neonatal team guidance, advice was given for cord direct antiglobulin test, full blood count and bilirubin at delivery. This case highlights the rare case of haemolytic disease of the fetus and newborn on a background of maternal low titre anti-E antibodies.

  • haematology (incl blood transfusion)
  • pregnancy
  • materno-fetal medicine
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  • Contributors TTML and PC co-wrote the main case report, with oversight, editing and review from EP-S, who initiated the writing of the case report following review of the case locally.

  • 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 Parental/guardian consent obtained.

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