Case report: IgG1 Rh antibodies causing moderate hemolytic disease of the newborn

A gravida 3, para 1, 32-year-old black female presented at 27 weeks gestation for routine prenatal serologic tests. She typed as group A, D positive, category D^III mosaic. IgG1 anti-D, -hr^B, and -E were identified in her serum. Ultrasound revealed an apparently normal fetus with no evidence of hydrops or ascites. Amniocentesis, performed at 30, 33, and 35 weeks, showed some evidence of hemolysis that did not increase over time. At 36 weeks of gestation, she delivered a full-term infant who was group A, D positive, E negative, with a 3+ direct antiglobulin test. The eluate revealed anti-D and -hr^B. Treatment of the hemolytic disease of the newborn included phototherapy, intravenous fluids, and transfusion of 60 mL of mother’s deglycerolized red blood cells. Immunohematology 1994;10:124–126.