{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T16:35:49Z","timestamp":1787070949126,"version":"build-2736575974"},"reference-count":10,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","license":[{"start":{"date-parts":[[2024,2,6]],"date-time":"2024-02-06T00:00:00Z","timestamp":1707177600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-sa\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:p>Transplacental ultrasound-guided intrauterine transfusion (IUT) acts as a lifesaving therapy to prevent fetal anemia or even to reverse fetal hydrops. IUTs are generally initiated after 22\u201324 weeks of gestation and repeated every 2\u20134-week period of gestation. Although Rh-Kell phenotype-matched, fresh irradiated leukoreduced donor-packed red cells help to increase fetal hemoglobin level, this invasive procedure can increase fetal complications by fetomaternal hemorrhage. Women receiving IUTs are noted to be high allo-responders to red cell antigens, which can cause enhanced antibody titer or the formation of additional antibodies which might complicate future pregnancies. Hereby, we are reporting the case of a multiparous woman who underwent three sessions of IUTs between 24 weeks and 31+-week period of gestation and developed an additional anti-C antibody which was incidentally detected during compatibility testing at 34 weeks, along with raised anti-D immunoglobulin G titer of 1024 from initial titer of 128.<\/jats:p>","DOI":"10.4103\/ajts.ajts_155_23","type":"journal-article","created":{"date-parts":[[2024,2,7]],"date-time":"2024-02-07T01:02:00Z","timestamp":1707267720000},"page":"141-144","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Emergence of additional anti-C with amplification of anti-D titer post-Rh-Kell phenotype-matched intrauterine transfusions in severe hemolytic disease of fetus"],"prefix":"10.4103","volume":"19","author":[{"given":"Suhasini","family":"Sil","sequence":"first","affiliation":[{"name":"Department of Transfusion Medicine, All India Institute of Medical Sciences, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daljit","family":"Kaur","sequence":"additional","affiliation":[{"name":"Department of Transfusion Medicine, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Latika","family":"Chawla","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dixa","family":"Kumari","sequence":"additional","affiliation":[{"name":"Department of Transfusion Medicine, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Madhulika","family":"Singh","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vaidehi","family":"Prasanth","sequence":"additional","affiliation":[{"name":"Department of Transfusion Medicine, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashish","family":"Jain","sequence":"additional","affiliation":[{"name":"Department of Transfusion Medicine, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gita","family":"Negi","sequence":"additional","affiliation":[{"name":"Department of Transfusion Medicine, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2024,2,6]]},"reference":[{"key":"R1-20260422","first-page":"388","article-title":"The prevalence of irregular erythrocyte antibodies among antenatal women in Delhi","volume":"9","author":"Pahuja","year":"2011","journal-title":"Blood Transfus"},{"key":"R2-20260422","doi-asserted-by":"crossref","first-page":"92","DOI":"10.1007\/s12288-013-0308-6","article-title":"Enhancement of antibody titre and development of additional red cell alloantibodies following intrauterine transfusion","volume":"32","author":"Dubey","year":"2016","journal-title":"Indian J Hematol Blood Transfus"},{"key":"R3-20260422","doi-asserted-by":"crossref","first-page":"159","DOI":"10.1016\/j.tmrv.2016.05.008","article-title":"Hemolytic disease of the fetus and newborn: Modern practice and future investigations","volume":"30","author":"Hendrickson","year":"2016","journal-title":"Transfus Med Rev"},{"key":"R4-20260422","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1056\/NEJM200001063420102","article-title":"Noninvasive diagnosis by Doppler ultrasonography of fetal anemia due to maternal red-cell alloimmunization. Collaborative group for Doppler assessment of the blood velocity in anemic fetuses","volume":"342","author":"Mari","year":"2000","journal-title":"N Engl J Med"},{"key":"R5-20260422","doi-asserted-by":"crossref","first-page":"259","DOI":"10.1007\/s12288-016-0729-0","article-title":"What is it really? Anti-G or Anti-D plus Anti-C: Clinical significance in antenatal mothers","volume":"33","author":"Das","year":"2017","journal-title":"Indian J Hematol Blood Transfus"},{"key":"R6-20260422","doi-asserted-by":"crossref","first-page":"939","DOI":"10.1111\/j.1537-2995.2012.03862.x","article-title":"High anti-HLA response in women exposed to intrauterine transfusions for severe alloimmune hemolytic disease is associated with mother-child HLA triplet mismatches, high anti-D titer, and new red blood cell antibody formation","volume":"53","author":"Verduin","year":"2013","journal-title":"Transfusion"},{"key":"R7-20260422","doi-asserted-by":"crossref","first-page":"189","DOI":"10.1055\/s-2006-934092","article-title":"Prevalence of new maternal alloantibodies after intrauterine transfusion for severe Rhesus disease","volume":"23","author":"Watson","year":"2006","journal-title":"Am J Perinatol"},{"key":"R8-20260422","doi-asserted-by":"crossref","first-page":"6.e1","DOI":"10.1016\/j.ajog.2006.10.895","article-title":"High additional maternal red cell alloimmunization after Rhesus- and K-matched intrauterine intravascular transfusions for hemolytic disease of the fetus","volume":"196","author":"Schonewille","year":"2007","journal-title":"Am J Obstet Gynecol"},{"key":"R9-20260422","doi-asserted-by":"crossref","first-page":"2736","DOI":"10.1182\/blood-2007-03-083105","article-title":"Inflammation enhances consumption and presentation of transfused RBC antigens by dendritic cells","volume":"110","author":"Hendrickson","year":"2007","journal-title":"Blood"},{"key":"R10-20260422","doi-asserted-by":"crossref","first-page":"213","DOI":"10.1016\/j.tmrv.2018.07.002","article-title":"Red blood cell alloimmunization in the pregnant patient","volume":"32","author":"Webb","year":"2018","journal-title":"Transfus Med Rev"}],"container-title":["Asian Journal of Transfusion Science"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/ajts.ajts_155_23","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T15:39:26Z","timestamp":1787067566000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/ajts.ajts_155_23"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,2,6]]},"references-count":10,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2025]]}},"URL":"https:\/\/doi.org\/10.4103\/ajts.ajts_155_23","relation":{},"ISSN":["0973-6247","1998-3565"],"issn-type":[{"value":"0973-6247","type":"print"},{"value":"1998-3565","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,2,6]]},"assertion":[{"value":"2023-07-31","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-09-17","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}