A Group O, Rh-negative woman with no evidence of antibodies delivers her first child who shows a slightly decreased hemoglobin and the presence of spherocytes on the peripheral blood film. The DAT is positive with polyspecific AHG and anti-IgG. The baby is Group A, Rh negative and is slightly jaundiced with a bilirubin of 2.1 mg/dl. What is the most likely cause of the baby's jaundice?

Question

Quizplus · Accepted Answer

The presence of spherocytes and a positive DAT with anti-IgG suggests ABO hemolytic disease of the fetus and newborn (HDFN), which occurs when the mother is O and the baby is A or B. The slightly decreased hemoglobin and jaundice also support this diagnosis. Normal physiologic jaundice is unlikely in this situation since the bilirubin level is elevated. Rh HDFN is ruled out since the baby is Rh negative. Other types of HDFN (such as Kell, Duffy, or Kidd) can cause hemolysis and jaundice, but these are less common than ABO HDFN.

A Group O, Rh-Negative Woman with No Evidence of Antibodies