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Haemolytic disease of the fetus and newborn: do not miss a positive maternal antierythrocyte antibody screen
  1. Nuno Serra de Almeida1,
  2. Crisbety Pinho2,
  3. Diogo Faim2 and
  4. Raquel Henriques3
  1. 1Pediatric Department, Centro Hospitalar Tondela Viseu, EPE, Viseu, Portugal
  2. 2Pediatric Department, Centro Hospitalar e Universitário de Coimbra, EPE, Coimbra, Portugal
  3. 3Department of Neonatology, Maternidade Doutor Daniel de Matos, Centro Hospitalar e Universitário de Coimbra, EPE, Coimbra, Portugal
  1. Correspondence to Dr Crisbety Pinho; crisbetypinho{at}gmail.com

Abstract

Jaundice is one of the most common situations during the neonatal period. Alloimmune haemolytic disease of the fetus and newborn (AHDFN) is a major cause of pathological jaundice during the neonatal period. Since the establishment of anti-D prophylaxis, other antigens have gained greater clinical importance. The maternal antierythrocyte antibody screen is of great importance in monitoring pregnancy and in predicting the risk of AHDFN. A positive result should alert to the possibility of AHDFN and promote close surveillance of fetal anaemia, as well as neonatal anaemia and hyperbilirubinaemia. We describe a case of AHDFN due to incompatibility of the Rhesus c (Rhc) subgroup, diagnosed in pregnancy, but without effective transmission of information in the perinatal period, so a positive maternal antierythrocyte antibody screen was missed. This case highlights the importance of non-RhD antigens in this disease, but also the importance of a successful handoff of information in the delivery room.

  • neonatal intensive care
  • pregnancy
  • neonatal health

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Footnotes

  • Contributors All authors took care of the newborn described in this article. NSdA did the bibliographic research, wrote the draft of the article, its graphics and proceeded to the corrections and adjustments that other authors have proposed. CP is the corresponding author, made significant contributions to the content of the manuscript and was responsible for the revision proposed by Editorial Team of the Journal. DF made contributions to the content of the draft of the manuscript. RH was responsible for the primary clinical evaluation of the newborn and for the interpretation of the results and clinical evolution. She was also involved in the critical revision of the article and gave final approval of the version to be published.

  • 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.

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