{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,12]],"date-time":"2026-06-12T08:59:19Z","timestamp":1781254759980,"version":"3.54.1"},"reference-count":24,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,4,9]],"date-time":"2026-04-09T00:00:00Z","timestamp":1775692800000},"content-version":"vor","delay-in-days":8,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T00:00:00Z","timestamp":1775001600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Case Reports"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>Isoimmunization and fetal anemia pose considerable challenges in obstetrics, especially when there is a documented history of RhD incompatibility or other antibodies that may threaten fetal well\u2010being. These conditions frequently result in serious complications, including hydrops fetalis, fetal anemia, and, in certain situations, fetal loss. Effective management of such pregnancies needs careful monitoring and prompt interventions, such as intrauterine transfusion (IUT), along with thorough post\u2010delivery follow\u2010up to safeguard both maternal and neonatal health. Due to ongoing uncertainties concerning the administration of Rh immunoglobulin (RhIg) in RhD\u2010negative mothers during the first trimester of pregnancy, specifically before 12\u2009weeks of gestation, this rare case series examines two pregnancies complicated by fetal anemia and isoimmunization, emphasizing the clinical trajectory, management approaches, and outcomes for the neonates involved. This presentation discusses two cases of Rh isoimmunized pregnant women with significant histories of early pregnancy loss. The first patient, a 27\u2010year\u2010old G3Ab2 woman, had experienced two previous miscarriages\u2014one at 9\u2009weeks induced pharmacologically and another spontaneous abortion at 8\u2009weeks without curettage. She underwent her first intrauterine transfusion (IUT) at 21\u2009weeks and 2\u2009days with an Anti\u2010D titer of 1:512 and a fetal hemoglobin level of 9.2\u2009mg\/dL. A total of two IUTs were performed, and she delivered a healthy neonate at term with normal Apgar and growth. The second patient, a 32\u2010year\u2010old G2Ab1 woman, had one prior medically induced abortion at 7\u2009weeks using misoprostol, with no surgical intervention. She received her first IUT at 24\u2009weeks and 5\u2009days, with a lower anti\u2010D titer of 1:164 and a fetal hemoglobin level of 5.1\u2009mg\/dL. Despite requiring four transfusions, she delivered at 37\u2009+\u20091\u2009weeks a healthy neonate with normal development. In the first case, the newborn presented with a bilirubin concentration 7.2 and exhibited positive results for anti\u2010D and anti\u2010C antibodies, both at elevated titers. In the subsequent case, the infant had a birth weight of 3\u2009kg, normal Apgar scores, and a hemoglobin level of 10.1. Upon discharge, the infant was reported to be in stable condition and demonstrated normal growth and development at 37\u2009months of age. The management of abortions occurring before 12\u2009weeks of gestation in women with a negative RhD and fetuses with a positive RhD is crucial for the prevention of isoimmunization. Therefore, it seems reasonable to administer RhIg in abortions under 12\u2009weeks to prevent future consequences.<\/jats:p>","DOI":"10.1002\/ccr3.72237","type":"journal-article","created":{"date-parts":[[2026,4,10]],"date-time":"2026-04-10T04:29:26Z","timestamp":1775795366000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Maternal Isoimmunization\u2010Associated Fetal Anemia After First\u2010Trimester Abortion: A Case Report and Literature Review"],"prefix":"10.1002","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0783-8108","authenticated-orcid":false,"given":"Fatemeh","family":"Golshahi","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology, Fellowship of Maternal Fetal Medicine Yas Hospital Complex, Tehran University of Medical Sciences  Tehran Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3862-2262","authenticated-orcid":false,"given":"Behrokh","family":"sahebdel","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Fellowship of Maternal Fetal Medicine, Maternal Fetal and Neonatal Research Center Yas Hospital Complex, Tehran University of Medical Sciences  Tehran Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5098-7945","authenticated-orcid":false,"given":"Fatemeh","family":"Rahimi\u2010Sharbaf","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Yas Hospital, Tehran University of Medical Sciences  Tehran Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3515-4985","authenticated-orcid":false,"given":"Mahboobeh","family":"Shirazi","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Fellowship of Maternal Fetal Medicine Yas Hospital Complex, Tehran University of Medical Sciences  Tehran Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8187-5738","authenticated-orcid":false,"given":"Nafiseh","family":"Saedi","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Fellowship of Maternal Fetal Medicine, Maternal Fetal and Neonatal Research Center Yas Hospital Complex, Tehran University of Medical Sciences  Tehran Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4608-170X","authenticated-orcid":false,"given":"Khadijeh","family":"Adabi","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, School of Medicine Yas Hospital, Tehran University of Medical Sciences (TUMS)  Tehran Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-5665-2302","authenticated-orcid":false,"given":"Arash","family":"Jafarieh","sequence":"additional","affiliation":[{"name":"Anesthesiology &amp; Critical Care Department Amir A'lam Hospital, Tehran University of Medical  Tehran Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maedeh","family":"Mollaalipour Amiri","sequence":"additional","affiliation":[{"name":"Tehran University of Medical Sciences, Yas Hospital Complex  Tehran Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7903-8364","authenticated-orcid":false,"given":"Zahra","family":"Hamidi Madani","sequence":"additional","affiliation":[{"name":"Reproductive Health Research Center, Department of Obstetrics &amp;Gynecology, School of Medicine Guilan University of Medical Sciences  Rasht Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,4,9]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjsrh-2021-201225"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(54)92446-0"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(70)92724-8"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jogc.2017.11.007"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.wombi.2020.01.008"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.crwh.2024.e00620"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0020-7292(99)90000-0"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.contraception.2024.110530"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/aogs.13606"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.4103\/jfmpc.jfmpc_1705_23"},{"key":"e_1_2_11_12_1","article-title":"Anti\u2010D Administration After Spontaneous Miscarriage for Preventing Rhesus Alloimmunisation","volume":"3","author":"Karanth L.","year":"2013","journal-title":"Cochrane Database of Systematic Reviews"},{"key":"e_1_2_11_13_1","volume-title":"Mollison's Blood Transfusion in Clinical Medicine","author":"Klein H. 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