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Case Reports in Obstetrics and Gynecology
Volume 2013, Article ID 413502, 4 pages
http://dx.doi.org/10.1155/2013/413502
Case Report

Pregnancy with a Severe Hemoglobinopathy: Unintended Consequences of Transfusions

1Department of Obstetrics and Gynecology, Women & Infants Hospital, The Warren Alpert Medical School of Brown University, Providence, RI 02905, USA
2Maternal-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, USA

Received 9 November 2012; Accepted 10 January 2013

Academic Editors: O. Oyesanya and A. Semczuk

Copyright © 2013 David Kim et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

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.