title: Severe hemolytic disease of the premature newborn due to RH1 incompatibility: a case report.
abstract: We report a case of dramatic outcome of severe hemolytic disease in a newborn due to RH1 incompatibility. A newborn with A RH1 blood group was admitted in the Mohammed V Military Teaching Hospital for the problem of hydrops fetalis associated with RH1 incompatibility. The blood group of his mother, aged 31, was AB RH1-negative and that of his 37 year old father was A RH1. The mother had a history of 4 term deliveries, 3 abortions, and 1 living child. There was no prevention by anti-D immunoglobulin postpartum. The mother's irregular agglutinin test was positive and the pregnancy was poorly monitored. The laboratory tests of the newborn showed a high total serum bilirubin level (30 mg/L) and macrocytic regenerative anemia (Hemoglobin=4 g/dL, mean corpuscular volume = 183 fL, reticulocytes count =176600/m3). The blood smear showed 1256 erythroblasts per 100 leukocytes, Howell-Jolly bodies and many macrocytes. The direct antiglobulin test was positive. He was transfused with red blood cell concentrates and treated with conventional phototherapy. The evolution was unfavourable; he died three days after the death of his mother. The monitoring of these high-risk pregnancies requires specialized centers and a close collaboration between the gynaecologist and the blood transfusion specialist to strengthen the prevention, as well as clinico-biological monitoring in patients with a history of RH1 fetomaternal alloimunization.
authors.affiliation: Laboratory of Hematology and Immunohematology, Mohammed V Military Teaching Hospital, Faculty of Medicine and Pharmacy, Mohammed V University, Rabat, Morocco.
authors.forename: Jean
authors.initials: J
authors.lastname: Uwingabiye
authors.affiliation: Laboratory of Hematology and Immunohematology, Mohammed V Military Teaching Hospital, Faculty of Medicine and Pharmacy, Mohammed V University, Rabat, Morocco.
authors.forename: Hafid
authors.initials: H
authors.lastname: Zahid
authors.affiliation: Laboratory of Hematology and Immunohematology, Mohammed V Military Teaching Hospital, Faculty of Medicine and Pharmacy, Mohammed V University, Rabat, Morocco.
authors.forename: Fayçal
authors.initials: F
authors.lastname: Labrini
authors.affiliation: Laboratory of Hematology and Immunohematology, Mohammed V Military Teaching Hospital, Faculty of Medicine and Pharmacy, Mohammed V University, Rabat, Morocco.
authors.forename: Abdelhak
authors.initials: A
authors.lastname: El Khazraji
authors.affiliation: Laboratory of Hematology and Immunohematology, Mohammed V Military Teaching Hospital, Faculty of Medicine and Pharmacy, Mohammed V University, Rabat, Morocco.
authors.forename: Anass
authors.initials: A
authors.lastname: Yahyaoui
authors.affiliation: Laboratory of Hematology and Immunohematology, Mohammed V Military Teaching Hospital, Faculty of Medicine and Pharmacy, Mohammed V University, Rabat, Morocco.
authors.forename: Rachid
authors.initials: R
authors.lastname: Hadef
authors.affiliation: Laboratory of Hematology and Immunohematology, Mohammed V Military Teaching Hospital, Faculty of Medicine and Pharmacy, Mohammed V University, Rabat, Morocco.
authors.forename: Nezha
authors.initials: N
authors.lastname: Messaoudi
keywords: Hemolytic disease of the newborn; RH1; alloimmunization; prevention