|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)
- 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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