title: Twin pregnancy complicated by severe hemolytic disease of the fetus and newborn due to anti-g and anti-C.
abstract: BACKGROUND
  Hemolytic disease of the fetus and newborn caused by anti-G antibodies is rare, and in most previously reported cases, leads to a mild anemia. The RhG antigen is usually found in association with both RhD and RhC. We report a case of a twin pregnancy affected by both anti-G and anti-C alloantibodies leading to severe hemolytic disease of the fetus and newborn requiring multiple intrauterine transfusions and prolonged postnatal therapy.
  
  
  METHODS
  A patient with a prolonged history of previously affected pregnancies due to anti-D and anti-C was subsequently found to be affected with anti-G instead. She required aggressive therapy during her pregnancy, initially with intravenous immune globulin and plasmapheresis until umbilical blood sampling and intrauterine transfusions were feasible.
  
  
  CONCLUSIONS
  Although hemolytic disease of the fetus and newborn due to anti-G antibodies is rare and usually mild, these pregnancies should be followed up closely and in utero therapy should be offered if necessary.
authors.affiliation: Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of North Carolina School of Medicine, Chapel Hill, North Carolina 27599-7516, USA. ttrevett@carolinaultrasound.com
authors.forename: Thomas N
authors.initials: TN
authors.lastname: Trevett
authors.forename: Kenneth J
authors.initials: KJ
authors.lastname: Moise
mesh_terms: D000328:Adult; D001787:Blood Group Incompatibility; D001805:Blood Transfusion, Intrauterine / Q000379:methods*; D004200:Diseases in Twins / Q000097:blood* / Q000276:immunology / Q000628:therapy; D004899:Erythroblastosis, Fetal / Q000276:immunology*; D005260:Female; D005313:Fetal Death; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use; D007231:Infant, Newborn; D007518:Isoantibodies / Q000097:blood* / Q000276:immunology; D010956:Plasmapheresis; D011247:Pregnancy; D011250:Pregnancy Complications, Hematologic / Q000097:blood / Q000276:immunology* / Q000628:therapy; D011256:Pregnancy Outcome; D011272:Pregnancy, Multiple; D012204:Rh-Hr Blood-Group System / Q000276:immunology*; D014427:Twins
chemical_list: D016756:Immunoglobulins, Intravenous; D007518:Isoantibodies; D012204:Rh-Hr Blood-Group System; C051138:anti-c antibody