Bombay blood type and use of red cell apheresis during pregnancy

Bombay blood type is among the rarest in the world and is associated with anti-H antibodies. These antibodies cause severe hemolysis when exposed to any blood product except Bombay and have been reported to cause hemolytic disease of the newborn.

A primigravid woman with Bombay blood type received erythropoietin and underwent autologous blood donation using red cell apheresis. Maternal anti-H immunoglobulin G antibodies were identified and serial evaluation of the middle cerebral artery peak systolic velocity was used to monitor for fetal anemia. Hemolytic disease of the newborn did not develop.

Red cell apheresis is a valuable procedure that results in two units of red blood cells per donation and was well tolerated during pregnancy.