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 Case 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)

• Mother types as Jk(a-), probable Rh genotype R¹R¹ (DCe/DCe)
• Anti-Jk^a, 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-Jk^a, 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.