{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T12:16:39Z","timestamp":1790079399589,"version":"4.0.1"},"reference-count":11,"publisher":"Hamad bin Khalifa University Press (HBKU Press)","issue":"3","license":[{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    <jats:bold>Background:<\/jats:bold>\n                    Rhesus (Rh) alloimmunization remains an important cause of fetal anaemia and perinatal morbidity despite the widespread use of anti-D immunoglobulin, particularly in regions with inadequate antenatal surveillance. Early detection of fetal anaemia using middle cerebral artery (MCA) Doppler ultrasonography and timely intervention are essential for improving neonatal outcomes.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Case presentation:<\/jats:bold>\n                    We report the case of a 35-year-old multigravida (G3P2L1) with Rh-negative blood group, managed at a tertiary-care referral centre in India. She had a previous history of neonatal death attributed to complications of Rh-isoimmunisation. During her current pregnancy, high antibody titres were detected at 32 weeks of gestation. MCA Doppler revealed severe fetal anaemia, following which a single intrauterine transfusion was performed at 33 weeks. Delivery was performed by caesarean section at 35 weeks and 4 days of gestation. The neonate required two double-volume exchange transfusions and intensive phototherapy in the immediate postnatal period. At 45 days of life, the infant developed late-onset normocytic normochromic anaemia, which was successfully managed with packed red blood cell transfusion.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Discussion:<\/jats:bold>\n                    This case highlights the importance of late third-trimester detection of severe fetal anaemia using MCA-peak systolic velocity (PSV) Doppler assessment, enabling timely intrauterine correction with a single transfusion and reducing the need for repeated invasive procedures. Despite antenatal optimization, the neonate required intensive postnatal management, including double-volume exchange transfusions, intravenous immunoglobulin (IVIG), and phototherapy, highlighting the continued impact of circulating maternal antibodies. Long-term haematological follow-up remained necessary.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Conclusion:<\/jats:bold>\n                    Early Doppler-based diagnosis, timely single intrauterine transfusion, structured neonatal intensive care, and long-term hematologic follow-up resulted in favourable survival with normal developmental progression at 15 months of age.\n                  <\/jats:p>","DOI":"10.5339\/qmj.2026.64","type":"journal-article","created":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T11:56:03Z","timestamp":1790078163000},"source":"Crossref","is-referenced-by-count":0,"title":["Timed and targeted transfusion in Rh isoimmunization: A case report on early detection and neonatal outcomes"],"prefix":"10.5339","volume":"2026","author":[{"given":"Sameena","family":"Haroon","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynaecology, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muskan","family":"Aggarwal","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haroon","family":"Hussain","sequence":"additional","affiliation":[{"name":"Department of Medicine, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9873-6283","authenticated-orcid":true,"given":"Adarsh","family":"Sugathan","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Manipal Hospitals, KMC Hospital, Jyothi Circle, Mangalore, Karnataka, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-9242-3145","authenticated-orcid":true,"given":"Shamathmika","family":"Rao","sequence":"additional","affiliation":[{"name":"Department of Neuromicrobiology, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1462-1006","authenticated-orcid":true,"given":"Nayanatara Arun","family":"Kumar","sequence":"additional","affiliation":[{"name":"Department of Physiology, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"3277","reference":[{"issue":"6:","key":"B1","series-title":"J Family Med Prim Care","first-page":"2507","article-title":"Maternal isoimmunization associated fetal anemia: A case report","volume":"13","author":"Jiandani\n \nF","year":"2024;","unstructured":"Jiandani\n \nF\n\n, \n\nBhalerao\n \nA\n\n, \n\nSomalwar\n \nS\n\n, \n\nChindhalore\n \nP\n\n, \n\nJaiswal\n \nY\n\n\n. \nMaternal isoimmunization associated fetal anemia: A case report\n. \nJ Family Med Prim Care\n. \n2024;\n13\n6:\n2507\n2510\n. \n\nhttps:\/\/doi.org\/10.4103\/jfmpc.jfmpc_1705_23"},{"issue":"2:","key":"B2","series-title":"Facts Views Vis ObGyn","first-page":"129","article-title":"Intrauterine transfusion for fetal anemia due to red blood cell alloimmunization: 14 years\u2019 experience in Leuven","volume":"7","author":"Pasman\n \nS","year":"2015;","unstructured":"Pasman\n \nS\n\n, \n\nClaes\n \nL\n\n, \n\nLewi\n \nL\n\n, \n\nVan Schoubroeck\n \nD\n\n, \n\nDebeer\n \nA\n\n, \n\nEmonds\n \nMP\n\n\n\n. \nIntrauterine transfusion for fetal anemia due to red blood cell alloimmunization: 14 years\u2019 experience in Leuven\n. \nFacts Views Vis ObGyn\n. \n2015;\n7\n2:\n129\n136\n."},{"issue":"1:","key":"B3","series-title":"Am J Obstet Gynecol","first-page":"S84","article-title":"Management of fetal anemia in red cell alloimmunization: comparison of intrauterine intravascular simple transfusion and exchange transfusion","volume":"210","author":"Guilbaud\n \nL","year":"2014;","unstructured":"Guilbaud\n \nL\n\n, \n\nGarabedian\n \nC\n\n, \n\nCarbonne\n \nB\n\n, \n\nDebarge\n \nV\n\n\n. \nManagement of fetal anemia in red cell alloimmunization: comparison of intrauterine intravascular simple transfusion and exchange transfusion\n. \nAm J Obstet Gynecol\n. \n2014;\n210\n1:\nS84\n. \n\nhttps:\/\/doi.org\/10.1016\/j.ajog.2013.10.173"},{"issue":"1:","key":"B4","series-title":"Int J Appl Basic Med Res","first-page":"73","article-title":"Rh isoimmunized pregnancy managed noninvasively: A report of two cases","volume":"7","author":"Jain\n \nD","year":"2017;","unstructured":"Jain\n \nD\n\n\n. \nRh isoimmunized pregnancy managed noninvasively: A report of two cases\n. \nInt J Appl Basic Med Res\n. \n2017;\n7\n1:\n73\n75\n. \n\nhttps:\/\/doi.org\/10.4103\/2229-516X.198535"},{"issue":"1:","key":"B5","series-title":"American journal of obstetrics and gynecology","first-page":"171","article-title":"Complications of intrauterine intravascular transfusion for fetal anemia due to maternal red-cell alloimmunization","volume":"192","author":"Van Kamp\n \nIL","year":"2005;","unstructured":"Van Kamp\n \nIL\n\n, \n\nKlumper\n \nFJ\n\n, \n\nOepkes\n \nD\n\n, \n\nMeerman\n \nRH\n\n, \n\nScherjon\n \nSA\n\n, \n\nVandenbussche\n \nFP\n\n\n\n. \nComplications of intrauterine intravascular transfusion for fetal anemia due to maternal red-cell alloimmunization\n. \nAmerican journal of obstetrics and gynecology\n. \n2005;\n192\n1:\n171\n7\n. \n\nhttps:\/\/doi.org\/10.1016\/j.ajog.2004.06.063"},{"issue":"3:","key":"B6","series-title":"Hematology, Transfusion and Cell Therapy","first-page":"289","article-title":"Effective management of foetal anaemia in Rh (D) alloimmunised pregnant women with intrauterine transfusion: a Systematic Review","volume":"46","author":"Prescott\n \nB","year":"2024;","unstructured":"Prescott\n \nB\n\n, \n\nJackson\n \nDE\n\n\n. \nEffective management of foetal anaemia in Rh (D) alloimmunised pregnant women with intrauterine transfusion: a Systematic Review\n. \nHematology, Transfusion and Cell Therapy\n. \n2024;\n46\n3:\n289\n99\n. \n\nhttps:\/\/doi.org\/10.1016\/j.htct.2023.07.013"},{"key":"B7","series-title":"BMJ Case Rep","first-page":"e227225","article-title":"Hyperferritinaemia following intrauterine transfusions for Rh isoimmunisation","volume":"12:","author":"Anne\n \nRP","year":"2019;","unstructured":"Anne\n \nRP\n\n, \n\nSundaram\n \nV\n\n, \n\nDutta\n \nS\n\n, \n\nKumar\n \nP\n\n\n. \nHyperferritinaemia following intrauterine transfusions for Rh isoimmunisation\n. \nBMJ Case Rep\n. \n2019;\n12:\ne227225\n. \n\nhttps:\/\/doi.org\/10.1136\/bcr-2018-227225"},{"issue":"Suppl 1:","key":"B8","series-title":"The Journal of Obstetrics and Gynecology of India","first-page":"327","article-title":"Intrauterine Transfusion for Fetal Anemia: An 8-Year Experience from a Tertiary Care Center: Z. Dias et al","volume":"75","author":"Dias\n \nZ","year":"2025;","unstructured":"Dias\n \nZ\n\n, \n\nElayedatt\n \nRA\n\n, \n\nKarthik\n \nA\n\n, \n\nKrishnan\n \nV\n\n\n. \nIntrauterine Transfusion for Fetal Anemia: An 8-Year Experience from a Tertiary Care Center: Z. Dias et al\n. \nThe Journal of Obstetrics and Gynecology of India\n. \n2025;\n75\nSuppl 1:\n327\n32\n. \n\nhttps:\/\/doi.org\/10.1007\/s13224-024-01985-7"},{"issue":"5:","key":"B9","series-title":"J Clin Med","first-page":"1362","article-title":"Intrauterine Transfusion for Rhesus Alloimmunization: A Historical Retrospective Cohort from A Single Reference Center in Brazil","volume":"13","author":"Pares\n \nDBDS","year":"2024;","unstructured":"Pares\n \nDBDS\n\n, \n\nPacheco\n \nGHAS\n\n, \n\nLobo\n \nGAR\n\n, \n\nAraujo\n \nE\n \nJ\u00fanior\n\n\n. \nIntrauterine Transfusion for Rhesus Alloimmunization: A Historical Retrospective Cohort from A Single Reference Center in Brazil\n. \nJ Clin Med\n. \n2024;\n13\n5:\n1362\n. \n\nhttps:\/\/doi.org\/10.3390\/jcm13051362"},{"key":"B10","series-title":"Cureus","first-page":"e6559","article-title":"Rhesus Isoimmunization: Lateonset Hemolytic Disease of the Newborn Without Jaundice","volume":"12:","author":"Haider\n \nM","year":"2020;","unstructured":"Haider\n \nM\n\n, \n\nMemon\n \nS\n\n, \n\nTariq\n \nF\n\n, \n\nFatima\n \nS\n\n, \n\nHameed\n \nA\n\n\n. \nRhesus Isoimmunization: Lateonset Hemolytic Disease of the Newborn Without Jaundice\n. \nCureus\n. \n2020;\n12:\ne6559\n. \n\nhttps:\/\/doi.org\/10.7759\/cureus.6559"},{"key":"B11","series-title":"ACOG practice bulletin","first-page":"192","article-title":"Management of alloimmunization during pregnancy","author":"American College of Obstetricians and Gynecologists","year":"2018;","unstructured":"American College of Obstetricians and Gynecologists\n\n. \nManagement of alloimmunization during pregnancy\n. \nACOG practice bulletin\n. \n2018;\n192\n. \n\nhttps:\/\/doi.org\/10.1097\/AOG.0000000000002528"}],"container-title":["Qatar Medical Journal"],"original-title":[],"link":[{"URL":"https:\/\/www.qscience.com\/view\/journals\/qmj\/2026\/3\/article-64.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.qscience.com\/downloadpdf\/journals\/qmj\/2026\/3\/article-64.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/www.qscience.com\/downloadpdf\/journals\/qmj\/2026\/3\/article-64.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T11:56:05Z","timestamp":1790078165000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.qscience.com\/view\/journals\/qmj\/2026\/3\/article-64.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026]]},"references-count":11,"journal-issue":{"issue":"3"},"URL":"https:\/\/doi.org\/10.5339\/qmj.2026.64","relation":{},"ISSN":["2227-0426"],"issn-type":[{"value":"2227-0426","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026]]}}}