Table 2.
Published case reports of HDFN caused by anti-Rh17 alloimmunization: outcome and transfusion therapy of HDFN
| Case | Authors [reference], year of publication | Order of pregnancies | HDFN and outcome | Transfusion therapy and other management of HDFN | Source of RBC for fetal and neonatal transfusion |
|---|---|---|---|---|---|
| 1 | De Torregrosa et al. [5], 1961 | First | Neonatal jaundice at age 24 h, at the fourth day clinical presentation of neonatal generalized edema and poor general condition; ET was late and neonate died toward the end of the procedure | 1 ET after 4 days | Maternal RBCs |
| Second | Stillborn fetus in 7th month of pregnancy | ||||
| 2 | Badakere and Bhatia [6], 1973 | Fifth | Neonatal death within the first 24 h | 1 ET (180 mL) | Maternal RBCs |
| Sixth | Neonatal death within the first 24 h | 1 ET (180 mL) | Maternal RBCs | ||
| 3 | Diao et al. [7], 1990 | Third | CS at 36th week of pregnancy; severe anemia and hyperbilirubinemia; after therapy baby is alive and in good health | 1 ET, 1 TUT | Incompatible RBCs phenotype ccDEE |
| 4 | Mertens et al. [8], 1997 | Second | CS in 39th week of pregnancy, severe neonatal anemia and hyperbilirubinemia; after therapy the infant is alive and in good health | 1 ET | Compatible thawed RBC (Bank of Frozen Blood) |
| 5 | Han et al. [9], 1997 | Third | CS, severe anemia (Hb 3.5 g/dL) and fetal hydrops; neonatal death due to generalized hydrops | 1 ET, 1 TUT | Incompatible RBCs (ET), maternal RBCs (TUT) |
| 6 | Whang et al. [10], 2000 | Third | Baby died because of HDFN | ||
| Fourth | CS in 34th week; three plasma exchange therapies during pregnancy before IUTs; after therapy the infant is alive and in good health | 3 IUT, 2 ET | Maternal RBCs (IUT), compatible RBCs from relatives (ET) | ||
| 7 | Lenkiewicz and Zupanska [11], 2000 | Second | Moderate HDFN | Phototherapy | |
| 8 | Deitenbeck et al. [12], 2002 | Fifth | CS in 34th week | 2 IUT, 1 ET, 1 TUT, IVIG | Maternal RBCs frozen before pregnancy |
| 9 | Brumit et al. [13], 2002 | Second | Moderate HDFN | Phototherapy only | |
| 10 | Aref et al. [14], 2002 | Second | Severe anemia (Hb 6 g/dL) and fetal hydrops, CS at 33rd week of pregnancy, resolution of neonatal hydrops after therapy; correction of duodenal atresia | 2 ET, IVIG, erythropoietin | Compatible thawed RBCs |
| 11 | Denomme et al. [15], 2004 | Second | Delivery at 30th week of pregnancy after premature rupture of membranes; severe anemia (Hb 6 g/dL) and hyperbilirubinemia; baby was discharged from hospital after 1 ET | 1 ET | Incompatible O RhD-negative RBCs |
| Third | CS due to fetal distress after induction of labor at 38th week of pregnancy; phototherapy was initiated at birth but was discontinued due to low bilirubin levels; follow-up 2 weeks later showed evidence of mild anemia that did not require transfusion | 7 IUT, phototherapy | Maternal ABO incompatible RBCs | ||
| 12 | Salamat et al. [16], 2004 | Fourth | CS in 8th month of pregnancy; intrauterine death due to fetal hydrops | No | |
| 13 | Hirose et al. [17], 2004 | First; blood transfusion before pregnancy | CS in 34th week, severe anemia and hyperbilirubinemia; after therapy the infant is alive and in good health | 1 IUT, 2 ET | Compatible fresh donor's RBCs |
| 14 | Shah et al. [18], 2005 | Fourth | Delivery in 37th week; after therapy baby is alive and in good health | 3 ET, 1 TUT, IVIG | Maternal RBCs (1 ET, 1 TUT); incompatible RBCs (2 ET) |
| 15 | Li et al. [26], 2010 | Second | Delivery 39th week; neonatal anemia (Hb 8.1 g/dL), severe hyperbilirubinemia and neonatal hydrops; after therapy the infant is alive and in good health | 1 ET, 3 TUT, IVIG, phototherapy, methylprednisolone | Incompatible RBCs, donors O RhD-positive phenotype ccEE |
HDFN, hemolytic disease of the fetus and newborn; Hb, hemoglobin; IUT, intrauterine transfusion; ET, exchange transfusion; TUT, top-up transfusion; IVIG, intravenous immunoglobulin; CS, cesarean section.