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[Danger of anti-erythrocyte antibodies during pregnancy]
J M Durand1, S Salas, C Gauthier
1Service de médecine interne, hôpital Sainte-Marguerite, Marseille.
Introduction:
Red cell autoantibodies are very rarely observed in pregnant women. We report one case related to the presence of a lupus anticoagulant.
Exegesis:
A 32-year-old woman had a history of two intrauterine deaths that had occurred at weeks 32 and 33, respectively. Due to the presence of a lupus anticoagulant, prednisone (20 mg/day) and subcutaneous calcium heparin were administered during her third pregnancy. The direct antiglobulin test remained positive throughout the pregnancy; however, hemolysis could not be detected. Caesarean section was done in emergency at week 29, due to fetal bradycardia related to severe fetal hemolysis.
Conclusion:
When autoimmune hemolysis occurs during pregnancy, risks for the fetus increase with the severity of hemolysis in the mother. It is thought that child mortality reflects the existence of anemia, rather than the existence of hemolysis. Our observation suggests that severe fetal hemolysis may occur, despite the absence of hemolysis in the mother.