Case Analysis of a Repeated Hydrops Fetalis Caused by Irregular Antibodies of Anti-E and Anti-c.

Background: Blood group irregular antibody is a major factor that may cause adverse pregnancy outcomes. We aimed to emphasize the importance of prenatal blood antibody screening and popularize antenatal care knowledge by sharing a case of hydrops fetalis caused by anti-E and anti-c alloimmunization antibodies.

Methods: We retrospectively analyzed the clinical and laboratory data of a pregnant woman with repeated fetal edema caused by anti-E and anti-c irregular antibodies. Irregular antibody screening, antibody identification, and antibody titer detection were performed.

Results: A pregnant woman aged 30 years old, in whom hydrops fetalis was found by color Doppler ultrasound at 32 + 5 gestation weeks. Irregular antibody screening was positive and anti-E and anti-c were detected in plasma. The results were negative by saline method. Antibody titers of anti-E and anti-c were 1,024 and 128, respectively, and Rh blood group was CCDee (R1R1). Eventually, a fatal termination had to be chosen for serious hydrops fetalis.

Conclusions: Hydrops fetalis, stillborn fetus, and kernicterus are the severest outcomes of hemolytic disease of the fetus and newborn (HDFN). Anti-E and anti-c are common alloantibodies that lead to adverse fetal outcomes. Such adverse pregnancy outcomes can be minimized by improving pregnant women's awareness of HDFN and reinforcing the management of irregular blood group antibodies during pregnancy.