Background: The incidence of hemolytic disease of the fetus and newborn (HDFN) has decreased since the introduction of Rh immunoglobulin prophylaxis in Rh(D)-negative pregnant women. Thus, the relative incidence of rare alloantibody-related HDFN has increased. The lack of available maternally matched red blood cells for transfusion in these cases may create management difficulties. Case: We report a case of anti-Kpb HDFN. Severe fetal anemia required intrauterine transfusion. Difficulty in obtaining Kpb-negative blood necessitated using the mother's donated RBCs. Conclusion: Severe HDFN with rare antibodies can be managed successfully using maternal blood.
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