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Background <p>Intrauterine transfusion (IUT) is a life-saving intervention for a prospective case of hemolytic disease of the newborn (HDN), but it carries a considerable risk of maternal sensitization and the formation of additional alloantibodies. In resource-constrained settings, the lack of extended antigen typing and limited access to compatible blood units pose significant challenges. Timely, coordinated inter-institutional efforts and innovative donor recruitment strategies are critical to ensuring safe transfusion support and optimal maternal–fetal outcomes.</p> Case Presentation <p>We share the case of a 24-year-old second gravida who presented with intrauterine fetal anaemia due to Rhesus D (RhD) disease, for whom transplacental ultrasound-guided intrauterine transfusion (IUT) was performed in a resource-poor setting. Following the procedure, she additionally developed anti-Kidd (anti-Jka) alloantibody, reducing the chances of receiving compatible blood to 20%. Fetal medicine and transfusion medicine departments from two different centers joined hands in managing the patient. Anticipating further IUT, postpartum hemorrhage, and exchange transfusions, O-negative, Jka-negative irradiated, leukoreduced packed red blood cells (PRBCs) compatible with the mother’s blood were arranged with the help of blood donors recruited through social media campaigns over a brief period and transfused twice. Finally, a healthy term fetus of 2.45 Kg was successfully delivered.</p> Conclusion <p>This case highlights the need for vigilant post-IUT alloantibody screening and underscores the importance of collaborative, innovative, and adaptive transfusion strategies in low-resource settings to manage rare alloimmunization scenarios and improve perinatal outcomes.</p>

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Development of Additional Alloantibody Following Intrauterine Transfusion and Its Management in a Resource-Poor Rural Setting: A Case Report

  • 期刊论文

  • 发表日期：

    2025年12月19日

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  • Nithya Mohanan,
  • Prasanth Perilakalathil

摘要

Background

Intrauterine transfusion (IUT) is a life-saving intervention for a prospective case of hemolytic disease of the newborn (HDN), but it carries a considerable risk of maternal sensitization and the formation of additional alloantibodies. In resource-constrained settings, the lack of extended antigen typing and limited access to compatible blood units pose significant challenges. Timely, coordinated inter-institutional efforts and innovative donor recruitment strategies are critical to ensuring safe transfusion support and optimal maternal–fetal outcomes.

Case Presentation

We share the case of a 24-year-old second gravida who presented with intrauterine fetal anaemia due to Rhesus D (RhD) disease, for whom transplacental ultrasound-guided intrauterine transfusion (IUT) was performed in a resource-poor setting. Following the procedure, she additionally developed anti-Kidd (anti-Jka) alloantibody, reducing the chances of receiving compatible blood to 20%. Fetal medicine and transfusion medicine departments from two different centers joined hands in managing the patient. Anticipating further IUT, postpartum hemorrhage, and exchange transfusions, O-negative, Jka-negative irradiated, leukoreduced packed red blood cells (PRBCs) compatible with the mother’s blood were arranged with the help of blood donors recruited through social media campaigns over a brief period and transfused twice. Finally, a healthy term fetus of 2.45 Kg was successfully delivered.

Conclusion

This case highlights the need for vigilant post-IUT alloantibody screening and underscores the importance of collaborative, innovative, and adaptive transfusion strategies in low-resource settings to manage rare alloimmunization scenarios and improve perinatal outcomes.