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Case Study A3 - Summary
 

TraQ Program of the BC PBCO

Monday, 26 June 2017

Case Study A3 - Summary

HISTORY

Mrs. D.M. is a 34 year old female admitted at 37 weeks gestation for induction of a twin pregnancy. She has a history of 2 prior pregnancies, with anti-Jka being reported during prenatal testing of the current pregnancy.

RESULTS: INITIAL PRETRANSFUSION TESTING (MOTHER)

Group B Rh positive

  • Antibody screen positive by PEG-IAT
  • Unexpected reactions with Jk(a-) screen cells and donor cells

RESULTS: ANTIBODY IDENTIFICATION AND PHENOTYPING

  • Mother types as Jk(a-), probable Rh genotype R1R1 (DCe/DCe)
  • Anti-Jka, anti-E, and anti-c identified

SEROLOGIC RESULTS (TWIN A)

  • Group B Rh positive, DAT positive (2+)
  • Red cells type as Jk(a+), probable Rh genotype R1R2 (CDe/cDE)
  • Red cells elute anti-Jka, anti-E, and anti-c

SEROLOGIC RESULTS (TWIN B)

  • Group B Rh positive, DAT positive (w+)
  • Red cells type as Jk(a-), probable Rh genotype R1r (CDe/cde)
  • Red cells elute anti-c

ANTIGEN PHENOTYPING (FATHER)

  • Red cells type as Jk(a+), probable Rh genotype R2r (cDE/cde)

OUTCOME

  • Twin A's total serum bilirubin on day 2 (0820 hrs, one-day post-delivery) was 78 µmol/L. Twin B's total serum bilirubin was monitored for two days: 78 µmol/L (0820 hrs, day 2), 103 µmol/L (2050 hrs, day 2), and 124 µmol/L (0815 hrs, day3).

    The twins did not require phototherapy. Neither of the twins nor Mrs. DM required transfusion.

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Last modified on Monday, 11 July 2011 15:22