Pregnancy with a Severe Hemoglobinopathy: Unintended Consequences of Transfusions

We report a case of a pregnant woman with a complex hemoglobinopathy who developed a symptomatic anemia at 28 weeks of gestation and was treated with multiple transfusions of type-specific packed red blood cells. Shortly thereafter, she developed a fever and joint pains, along with laboratory values...

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Main Authors: David Kim, Hector Mendez-Figueroa, Brenna L. Anderson
Format: Article
Language:English
Published: Hindawi Limited 2013-01-01
Series:Case Reports in Obstetrics and Gynecology
Online Access:http://dx.doi.org/10.1155/2013/413502
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spelling doaj-f20068cc46ac4476864cec3f140227ac2020-11-24T21:13:24ZengHindawi LimitedCase Reports in Obstetrics and Gynecology2090-66842090-66922013-01-01201310.1155/2013/413502413502Pregnancy with a Severe Hemoglobinopathy: Unintended Consequences of TransfusionsDavid Kim0Hector Mendez-Figueroa1Brenna L. Anderson2Department of Obstetrics and Gynecology, Women & Infants Hospital, The Warren Alpert Medical School of Brown University, Providence, RI 02905, USAMaternal-Fetal Medicine Clinic, Department of Obstetrics and Gynecology, Women & Infants Hospital, The Warren Alpert Medical School of Brown University, 101 Dudley Street, 3rd Floor, Providence, RI 02905-2401, USAMaternal-Fetal Medicine Clinic, Department of Obstetrics and Gynecology, Women & Infants Hospital, The Warren Alpert Medical School of Brown University, 101 Dudley Street, 3rd Floor, Providence, RI 02905-2401, USAWe report a case of a pregnant woman with a complex hemoglobinopathy who developed a symptomatic anemia at 28 weeks of gestation and was treated with multiple transfusions of type-specific packed red blood cells. Shortly thereafter, she developed a fever and joint pains, along with laboratory values consistent with hemolysis. Timing suggested a delayed transfusion reaction. An extensive evaluation including red blood cell antigen identification and cross-reaction failed to reveal the cause for her hemolysis. Despite her critically low hemoglobin levels, her transfusions were withheld in an attempt to allow the patient to recover conservatively. With this strategy, her hemoglobin remained below her baseline, but her symptoms began to improve. Her laboratory values normalized, and hemolysis was no longer evident. Three weeks later, her hemoglobin levels returned back to her baseline without additional intervention. She went on to deliver a full-term male infant.http://dx.doi.org/10.1155/2013/413502
collection DOAJ
language English
format Article
sources DOAJ
author David Kim
Hector Mendez-Figueroa
Brenna L. Anderson
spellingShingle David Kim
Hector Mendez-Figueroa
Brenna L. Anderson
Pregnancy with a Severe Hemoglobinopathy: Unintended Consequences of Transfusions
Case Reports in Obstetrics and Gynecology
author_facet David Kim
Hector Mendez-Figueroa
Brenna L. Anderson
author_sort David Kim
title Pregnancy with a Severe Hemoglobinopathy: Unintended Consequences of Transfusions
title_short Pregnancy with a Severe Hemoglobinopathy: Unintended Consequences of Transfusions
title_full Pregnancy with a Severe Hemoglobinopathy: Unintended Consequences of Transfusions
title_fullStr Pregnancy with a Severe Hemoglobinopathy: Unintended Consequences of Transfusions
title_full_unstemmed Pregnancy with a Severe Hemoglobinopathy: Unintended Consequences of Transfusions
title_sort pregnancy with a severe hemoglobinopathy: unintended consequences of transfusions
publisher Hindawi Limited
series Case Reports in Obstetrics and Gynecology
issn 2090-6684
2090-6692
publishDate 2013-01-01
description We report a case of a pregnant woman with a complex hemoglobinopathy who developed a symptomatic anemia at 28 weeks of gestation and was treated with multiple transfusions of type-specific packed red blood cells. Shortly thereafter, she developed a fever and joint pains, along with laboratory values consistent with hemolysis. Timing suggested a delayed transfusion reaction. An extensive evaluation including red blood cell antigen identification and cross-reaction failed to reveal the cause for her hemolysis. Despite her critically low hemoglobin levels, her transfusions were withheld in an attempt to allow the patient to recover conservatively. With this strategy, her hemoglobin remained below her baseline, but her symptoms began to improve. Her laboratory values normalized, and hemolysis was no longer evident. Three weeks later, her hemoglobin levels returned back to her baseline without additional intervention. She went on to deliver a full-term male infant.
url http://dx.doi.org/10.1155/2013/413502
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AT hectormendezfigueroa pregnancywithaseverehemoglobinopathyunintendedconsequencesoftransfusions
AT brennalanderson pregnancywithaseverehemoglobinopathyunintendedconsequencesoftransfusions
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