Fatal hydrops fetalis caused by anti-D in a mother with partial D.
BACKGROUND
Rare cases of hemolytic disease of the newborn occur in women with genetic variants of the D antigen. A partial D variant might be suspected when typing for the D antigen shows weaker-than-normal reactions (weak D). Historically, patients with a weak D phenotype have not been considered candidates for Rh immune globulin prophylaxis.


METHODS
A gravida 2, para 1 woman with A-positive blood type, delivered an infant who died from severe hemolytic disease of the newborn 6 days after birth. Anti-D, undetectable at the first prenatal visit, was identified (titer 1:64) at delivery. The mother's red cells were partial D(VI) phenotype.


CONCLUSIONS
Although severe hemolytic disease in patients with partial D is rare, this neonatal death illustrates the need for a change in management of women with weak D.
Cannon
Michael
M
Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Geisinger Medical Center, Danville, Pennsylvania 17821, USA.
Pierce
Richard
R
Taber
Evan Beth
EB
Schucker
Jodi
J
D000328:Adult; D004899:Erythroblastosis, Fetal / Q000209:etiology*; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D015160:Hydrops Fetalis / Q000209:etiology*; D007518:Isoantibodies / Q000276:immunology*; D011247:Pregnancy; D012204:Rh-Hr Blood-Group System / Q000276:immunology*
D007518:Isoantibodies; D012204:Rh-Hr Blood-Group System