# Perinatal Hemolytic Disease Due to Anti-Jkb: A Case Report

## TL;DR

A pregnant woman's lack of antibody screening led to complications in her twins, highlighting the importance of prenatal blood testing.

## Contribution

Highlights the clinical importance of indirect antiglobulin testing in pregnant women to prevent hemolytic disease.

## Key findings

- Anti-Jkb antibody was identified during pre-transfusion testing in a pregnant woman.
- Failure to perform IAT in prior pregnancies contributed to perinatal complications.
- Twin 1 died from asphyxia, while Twin 2 required treatment for jaundice and anemia.

## Abstract

This is a case report of a pregnant woman, with a history of cesarean section in a previous twin pregnancy, admitted due to premature rupture of membranes and investigation of anemia during her fifth pregnancy. During the cesarean section, she experienced significant hemorrhage, prompting a request for a red blood cell concentrate. During pre-transfusion testing, it was found that she was O positive, and an anti-erythrocyte antibody was identified, specifically anti-Jkb. It is noteworthy that despite her numerous previous pregnancies, there was no record of indirect antiglobulin testing (IAT) or irregular antibody screening during prenatal care. The outcome for twin 1 was perinatal asphyxia, resulting in death within 24 hours. Twin 2 developed jaundice and anemia, requiring phototherapy and red blood cell transfusions. This case underscores the need to consider clinical history and the importance of performing IAT in pregnant women, regardless of blood type.