Autologous intrauterine transfusion in a case of anti-U

Minor red blood cell antibodies are becoming a more common cause of hemolytic disease of the newborn. Anti-U are a rare alloantibody found almost exclusively in people of black descent. There is limited experience to guide the management of pregnancies complicated by anti-U. Furthermore, there is often no suitable cross-matched blood available for transfusion of a patient with anti-U.

A 21-year-old P0G1 presented at 25 weeks' gestation with D- disease in pregnancy. She had a significant indirect antiglobulin test titer of 512. Anti-U were identified and no suitable cross-matched blood was available. Maternal blood was prepared for autologous intrauterine fetal transfusion. Two such transfusions were performed.

A healthy fetus delivered at 32 weeks that did not require phototherapy or an exchange transfusion.

Autologous transfusion of prepared maternal blood provides a safe option for intrauterine fetal therapy in pregnancies complicated by rare alloantibodies.