A CASE REPORT: ANTI-G DETECTION AND MANAGEMENT IN PREGNANCY

Abstract

Introduction

Red blood cells (RBCs) that carry  RhD &/or RhC antigens have the G antigen (Rh12). Since anti-G antibodies show up on antibody screening as anti-D along with anti-C patterns, they were frequently overlooked. To prevent hemolytic disease of the fetus as well as newborn (HDFN) to guide optimal care, it is imperative to detect Rh-negative pregnant mothers.

Case Report

A Rh-negative pregnant woman(32yr/old) presented for antenatal checkup at 10 weeks of gestation. Initial screening revealed a positive indirect antihuman globulin test, with antibody screening patterns evocative of anti-D as well as anti-C. Advanced immunohematological techniques, which included adsorption-elution studies, confirmed the existence of D, C antigen, as well as anti-G antibodies. Antibody titers rose to critical levels of 32 by 33 weeks of gestation, accompanied by ultrasound findings suggestive of fetal anemia based on elevated middle cerebral artery peak systolic volume (>1.5MoM). The patient was managed with steroids for fetal lung maturity, and at 34 weeks C-section is performed. Postnatally, the neonate exhibited signs of HDFN with elevated bilirubin levels, which were successfully managed with phototherapy.

Discussion

This case underscores the clinical significance of distinguishing anti-G from anti-D as well as anti-C antibodies in Rh-negative pregnancies. Early diagnosis facilitated appropriate fetal monitoring and timely interventions, preventing severe complications.

Conclusion

Identifying anti-G antibodies through advanced immunohematological methods is vital for the management of Rh alloimmunization and optimizing maternal and neonatal outcomes. This case emphasizes the need for regular monitoring, multidisciplinary caste, and the critical role of precise antibody characterization in preventing complications in future pregnancies.