ASPHO October 2014 Case Quiz

Page 1 Questions
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Hemolytic Disease of the Fetus and Newborn
Angela Scott, MD; Meghan Delaney, DO MPH

The newborn female of a now gravida 4 para 3 mom with maternal history Rh D, C, and Jka (Kidd) alloimmunization during a prior pregnancy presented with anemia. There was fetal anemia at 30 weeks’ gestation for which she received two intrauterine transfusions. She was delivered via C-section at 34 weeks because of fetal distress. At birth, hematocrit was 19.4% and bilirubin was 6.5 mg/dl. The child’s antibody screen was positive for anti-D, anti-C, and anti-Jka antibodies. She required a 10-day neonatal intensive-care unit stay during which time she received intravenous immunoglobulin, blood transfusions, and phototherapy.
1. The most common form of hemolytic disease of the fetus and newborn (HDFN) is due to which of the following?