A rare case of maternal anti-m antibody causing autoimmune hemolytic anaemia in newborn

Abstract

Maternal antibodies against fetal red blood cells can cause hemolytic disease of the fetus and newborn (HDFN), leading to fetal anemia, fetal ascites (hydrops), and postnatal complications. While anti-D antibodies are the most common cause, other antibodies such as anti-M, anti-c, and anti-K1 can also be clinically significant. A 34-year-old woman (G2A1) with a prior second-trimester medical termination of pregnancy was found to have anti-M antibodies in her current pregnancy. Serial monitoring with blood tests and fetal Doppler scans indicated a risk of fetal anemia. Antenatal monitoring using ICT titers and MCA Doppler was performed for early detection of fetal complications. She delivered a preterm neonate (2.68 kg) who required NICU care, ventilation, phototherapy, and antigen-negative blood transfusions. Both mother and baby recovered well. Early detection of rare maternal antibodies, careful fetal surveillance, and planning for safe transfusions are essential for managing alloimmunized pregnancies. A multidisciplinary approach improves outcomes for both mother and newborn.