An Unusual Case of Hemolytic Disease of Newborn Due to ABO and Rh Isoimmunization

Anti-D is the most common cause of hemolytic disease of the newborn (HDN) in the developing countries even after the introduction of anti-D immunoprophylaxis. Still, ABO incompatibility and other alloantibodies against minor blood group antigens have emerged as significant causes of HDN. Moreover, ABO incompatibility acts as a protective barrier to the expression of Rh isoimmunization. Here we are presenting a case of HDN where both Rh and ABO incompatibility co-existed with their manifestations in a B positive neonate born to an O positive mother. Use of appropriate elution technique can aid in the diagnosis of such cases. Hence, antenatal screening of all mothers irrespective of their Rh D status can help in early diagnosis and proper management that can decrease the neonatal morbidity and mortality.