Review article: Management of Three Cases of Hemolytic Disease of the Fetus and Newborn Due to Anti-Rh17 Alloimmunization Within the Same Family by a Rural Hospital Blood Bank

Yan Zheng

Abstract

Hemolytic disease of the fetus and newborn (HDFN) due to anti-Rh17 alloimmunization is rare, with very few cases reported among siblings in the same family. This case series describes three biological sisters, all with blood type O and RhCE-null phenotype (genotype D--/D--), who were evaluated over a three-year period. Two of the sisters developed anti-Rh17 antibodies due to pregnancy, resulting in three separate cases of HDFN in their newborns. The pregnancies were managed collaboratively by a rural hospital blood bank, a tertiary care hospital, and several reference laboratories. Management strategies included prenatal antibody screening, identification and titration, intrauterine interventions, and postnatal blood transfusions using antigen-compatible red blood cells to treat fetal anemia and hyperbilirubinemia. Despite limited resources in the rural setting, coordinated multidisciplinary care enabled the successful management of these complex cases. This report highlights the critical role of early detection, the availability of rare blood units, and the value of collaboration across healthcare systems. It also emphasizes the importance of specialized knowledge in transfusion medicine for managing rare maternal antibodies like anti-Rh17 to improve neonatal outcomes.

Keywords: Hemolytic disease of the fetus and newborn (HDFN), anti-Rh17, RhCE-null phenotype, D--/D--

Int. J. Bio. Lab. Sci 2025(14)2:72-79 【PDF】