ABO incompatibility: its impact on pregnancy and neonate

Authors

  • U. Nagashree Department of Obstetrics and Gynecology, Apollo Womens Hospitals, Chennai, Tamil Nadu, India
  • Swetha P. Department of Obstetrics and Gynecology, Apollo Womens Hospitals, Chennai, Tamil Nadu, India
  • Sumana Manohar Department of Obstetrics and Gynecology, Apollo Womens Hospitals, Chennai, Tamil Nadu, India
  • Latha Kanchi Parthasarathy Department of Pediatrics and NICU, Apollo Childrens Hospitals, Chennai, Tamil Nadu, India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20190321

Keywords:

ABO incompatibility, Anemia, Hemolytic disease

Abstract

ABO incompatibility is one of the most common cause of haemolytic disease of fetus and new-born (HDFN). The expression of ABO incompatibility in most of the cases is mild due to the lower expression of A and B Antigens on fetal red cells. ABO incompatibility has affected the first pregnancy and is milder in the subsequent pregnancies.  However, we describe this case with unusually severe form of ABO incompatibility which had an effect not only in her first pregnancy but also in all her subsequent pregnancies, evident as recurrent abortions and both her neonates developed pathological jaundice requiring exchange transfusion. It also emphasizes the fact that ABO incompatibility is not always a benign condition and should be considered in all babies whose mothers have O blood group, even in the presence of a negative DAT. Anticipation of ABO incompatibility not only in the first pregnancy but also in the subsequent pregnancies is necessary. Early diagnosis with cord blood bilirubin can prevent neonatal morbidity. 

References

Chavez GF, Mulinare J, Edmonds LD. Epidemology of Rh haemolytic disease of the newborn in the United states. J Am Med Assoc. 1991;256:3270-4.

Roberts IA. The changing face of haemolytic disease of the newborn. Early Human Develop. 2008;84(8):515-23.

Thakral B, Agrawal SK, Krishan Dhawan H, Saluja K, Dutta S, Marwaha N. First report from India of haemolytic disease of newborn by anti-c and anti-E in Rh (D) positive mothers. Hematol. 2007;12(5):377-80.

Wu KH, Chu SL, Chang JG, Shib MC, Peng CT. Haemolytic disease of the newborn due to maternal irregular antibodies in the Chinese Populat Taiwan. Transf Med. 2003;13:311-4.

Schaap T, Shemer R, Palti Z, Sharon R. ABO incompatibility and reproductive failure. I. Prenatal selection. Am J Human Genet. 1984;36(1):143.

Malekasgar AM. ABO blood group prevalence in spontaneously repeated abortion. Turk J Haematol. 2004;2004(21):181-7.

Soni N, Mukherjee BM. A study on foetal wastage and ABO blood groups incompatibility among the Gonds of Garriyaband, Chhattisgarh, India. Anthropol. 2009;11(3):229-31.

Ogunlesi TA, Dedeke IO, Adekanmbi AF, Fetuga MB, Ogunfowora OB. The incidence and outcome of bilirubin encephalopathy in Nigeria: a bi-centre study. Niger J Med: J National Assoc Resi Doctors Niger. 2007;16(4):354-9.

Richon J, Streiff F, Genett B, Landes P, Brunel G, Raffoux C, et al. Value of the Coombs-Bromeline test in ABO feto-maternal blood incompatibilities. Bullet Federat Societ Gynecol Obstet French Lang. 1970;22(5):533-7.

Onesimo R, Rizzo D, Ruggiero A, Valentini P. Intravenous immunoglobulin therapy for anti-E hemolytic disease in the newborn. J Maternal-Fetal Neonat Med. 2010;23(9):1059-61.

Nasseri F, Mamouri GA, Babaei H. Intravenous immunoglobulin in ABO and Rh hemolytic diseases of newborn. Saudi Med J. 2006;27(12):1827-30.

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Published

2019-01-25

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Section

Case Reports