Manipal: A patient was referred to Kasturba Hospital for the management of an O-negative pregnancy with a positive indirect Coombs test. She was diagnosed with a very rare blood group, Bombay Negative, after immunohematological testing at Kasturba Hospital Blood Center. It is very difficult to check for the anti-D presence among Bombay phenotype patients. An adsorption technique was used to remove all the anti-H and rule out the presence of anti-D.
Dr. Shamee Shastry, professor and head of Kasturba Hospital Blood Center, said that this case was challenging for both the transfusion medicine specialists and the obstetricians to manage as there are only a few donors with this rare blood group in the entire country, and we sought for autologous blood collection in this case after increasing her haemoglobin level with the help of hematinics. In addition, erythropoietin injections and iron injections were used to improve pre-delivery haemoglobin. Obstetric care was further complicated by FGR (Fetal Growth Restriction) along with poor blood supply to fetus. Fetus was also at risk of anemia due to maternal antibodies, for which additional intense monitoring was done.
Dr. Akhila Vasudeva, professor and head of the division of foetal medicine, managed the case with continuous monitoring of the fetus and managed to deliver the baby by bloodless surgery. She emphasised the importance of antenatal antibody screening and blood grouping during pregnancy for better patient management. Kasturba Hospital’s chief operating officer, Dr Anand Venugopal , and medical superintendent, Dr Avinash Shetty, praised the team of doctors for their timely diagnosis of a rare blood phenotype and successful case management.
