{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T19:20:49Z","timestamp":1781551249785,"version":"3.54.5"},"reference-count":21,"publisher":"Wiley","license":[{"start":{"date-parts":[[2019,2,24]],"date-time":"2019-02-24T00:00:00Z","timestamp":1550966400000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Case Reports in Obstetrics and Gynecology"],"published-print":{"date-parts":[[2019,2,24]]},"abstract":"<jats:p><jats:italic>Objective<\/jats:italic>. We present a case of fetal severe anemia associated with Jra alloimmunization, which was managed using Doppler measurement of the peak systolic velocity of the fetal middle cerebral artery (MCA-PSV) and intrauterine transfusion (IUT) of Jr(a+) red blood cells (RBCs). We also review the previous case reports on fetal or neonatal anemia associated with Jra alloimmunization.<jats:italic>Case Report<\/jats:italic>. A woman with Jra alloimmunization was referred to our department at 29 weeks of gestation. As fetal MCA-PSV exceeded 1.55 multiples of the median, fetal blood sampling was performed and demonstrated severe anemia. During the course, a total of two IUTs were performed using Jr(a+) RBCs. The neonate was delivered by repeated cesarean section at 35 weeks of gestation and showed no apparent signs of hemolysis.<jats:italic>Conclusion<\/jats:italic>. Based on the literature review, fetal anemia associated with Jra alloimmunization becomes severe during mid-gestation and may not develop during late gestation. The severity of fetal anemia is predicted by MCA-PSV Doppler assessment rather than the maternal anti-Jra titers. Timely IUT of Jr(a+) RBCs can help to prolong the pregnancy to term in emergency situations wherein compatible blood of Jr(a-) RBCs is not available soon.<\/jats:p>","DOI":"10.1155\/2019\/5174989","type":"journal-article","created":{"date-parts":[[2019,2,24]],"date-time":"2019-02-24T23:31:21Z","timestamp":1551051081000},"page":"1-5","source":"Crossref","is-referenced-by-count":4,"title":["Successful Management of the Fetal Severe Anemia Associated with Jra Alloimmunization by Intrauterine Transfusion of Jr(a+) Red Blood Cells"],"prefix":"10.1155","volume":"2019","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0509-7812","authenticated-orcid":true,"given":"Masatake","family":"Toshimitsu","sequence":"first","affiliation":[{"name":"Department of Maternal and Fetal Medicine, Miyagi Children\u2019s Hospital, Miyagi 989-3126, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shinichi","family":"Nagaoka","sequence":"additional","affiliation":[{"name":"Department of 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