Status:
Ready to upload
Record number:
1187
Adverse Occurrence type:
MPHO Type:
Estimated frequency:
This is a rare complication.
Time to detection:
8.5 weeks after the prophylactic Rh IgG administration.
Alerting signals, symptoms, evidence of occurrence:
At delivery, the newborn was markedly jaundiced with a total bilirubin of 6.3 mg/dL, which reached more than 20 mg/dL after 6 days. The newborn's lactate dehydrogenase (LDH) was 485 U/L (normal, <226 U/L) and further laboratory studies revealed reticulocytosis (17.2%; normal range, 0.36%-1.9%) and a hemoglobin (Hb) of 14.3 g/dL (normal for age range, 13.4-19.8 g/dL) that decreased to 11.5 g/dL (normal for age range, 13.5-22.6 g/dL) by Day-of-life 7.
Demonstration of imputability or root cause:
The newborn's direct antiglobulin test (DAT) was positive for IgG, with an anti-D identified by elution studies in the context of neonatal anemia, elevated bilirubin, increased LDH and reticulocytois.
Imputability grade:
3 Definite/Certain/Proven
Groups audience:
Keywords:
Suggest new keywords:
RhIg, hemolytic disease of the new born, passive anti-D
Suggest references:
Cohen, D.H., Johnson, M.S., Liang,W.H., McDaniel, H.L. and Young, P.P.(2014). Clinically significant hemolytic disease of the newborn secondary to passive transfer of anti-D from maternal RhIG. Transfusion 54(11); 2863-6. DOI 10.1111/trf.12698.