An early-term, 2,860-g female infant is delivered via caesarean section by a 28-year-old gravida 3, para 1-1-1 woman. Her second pregnancy had terminated in an abortion 4 years ago with the cause unknown.

Results of serologic studies at the time of her previous pregnancies are not available, but the antibody screen (3-cell panel, Immucor Inc, Peachtree Corners, GA) during the present pregnancy is positive. The mother’s red blood cells (RBCs) are typed as B Rh (D) positive. The sample reacts with all cells in the 16-cell panel (Capture-R Ready-ID, Immucor Inc) and 11 cell panels (ID DiaPanel, Biorad Labs, Hercules, CA). The auto control and direct antiglobulin test results are negative. The reaction pattern seen on screening and identification panels indicates the presence of an RBC alloantibody to a high-frequency antigen. Crossmatch with multiple B-positive and O-positive RBC units are incompatible on Coombs testing. Extended phenotyping of the mother for...

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