Secondary Postpartum Hemorrhage Presenting With Bombay Blood Group: A Case Report

Shaik, Likhita; Ravalani, Abhimanyu; Devara, Janaki; Rathore, Sawai Singh; Singh, Romil

doi:10.7759/cureus.9758

Cited by 3 publications

(4 citation statements)

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“…Studies describing antenatal management of Bombay patients are limited. There are 11 published reports [7][8][9][10][11][12][13][14][15][16][17] with only one having twins. 14 Pleasingly, all mothers and all except one baby 12 survived the delivery and neonatal challenges of Bombay phenotype.…”

Section: Discussionmentioning

confidence: 99%

“…19 In one case, two doses of erythropoietin were also employed to optimize hemoglobin pre-delivery. 11 Anti-H can cause HDFN however this is uncommon -1 out of 4 pregnancies in one study 20 and 4/19 across all case reports [7][8][9][10][11][12][13][14][15][16][17] and adverse outcomes are exceedingly rare. The antibody titer does not reliably predict its occurrence or severity.…”

Section: Discussionmentioning

confidence: 99%

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Navigating the challenges of Bombay phenotype (O_h) and twin pregnancy; a case report and literature review

Krigstein

Cromer

2021

Transfusion

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Background: Bombay phenotype (O h ) is a rare blood group and poses unique challenges during pregnancy, including an adequate supply of blood products in case of postpartum hemorrhage (PPH) and the risk of hemolytic disease of the fetus and newborn (HDFN). Case reports of antenatal care in this cohort are scarce. Herein, we present a case of twin pregnancy in an O h woman and outline her multidisciplinary management. We summarize the literature to better inform decision-making and patient blood management in the antenatal care of O h women. Case description: A 22-year-old G1P0 presented at 15 weeks gestation with dichorionic diamniotic twins and known O h phenotype. Hematinics were optimized to minimize anemia. Anti-H titers were tracked and were 1:256 at both 28 and 36 weeks gestation. Regular middle cerebral artery dopplers were performed to assess for fetal anemia. There was constant communication with obstetrics and anesthetics teams. Both autologous frozen and directly donated fresh red cells were available as part of a clear, detailed transfusion plan. Transfusion was not required and neither child was affected by HDFN. The neonates were group O, DAT negative, and group A, DAT positive. Maternal anti-A was detected in the neonatal eluate. Conclusion: To our knowledge, this is only the second report of twin pregnancy in an O h female and the first time a detailed transfusion plan has been published. Through employing patient blood management strategies, engaging a collaborative multidisciplinary approach, and establishing a clear delivery plan, the antenatal challenges of Bombay phenotype are surmountable. K E Y W O R D Santi-H, Bombay (O h ) blood group, hemolytic disease of the fetus and newborn, pregnancy

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Navigating the challenges of Bombay phenotype (O_h) and twin pregnancy; a case report and literature review

Krigstein

Cromer

2021

Transfusion

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“…However, abnormal values of LDH, haptoglobin, bilirubin, and creatinine depict a hemolytic cause of anemia and thrombocytopenia. Other clues like fever and neurological symptoms suggest more life-threatening issues like TTP and DIC [9,[11][12]. However, as is wellknown that acquired TTP is caused by medications (chemotherapeutic drugs, ticlopidine, clopidogrel, cyclosporine A, hormone therapy, and estrogens), viral infections (EBV, hepatitis B, C, HIV, varicella), and chronic diseases like lupus, rheumatoid arthritis, and cancers.…”

Section: Diagnosis: Scc Vs Ttpmentioning

confidence: 99%

Parvovirus Infection and Thrombotic Thrombocytopenic Purpura in an Adult Patient With Sickle Cell Beta-Thalassemia

Shaik¹,

Ranjha²,

Katta³

et al. 2021

Cureus

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Parvovirus infection and thrombotic thrombocytopenic purpura (TTP) are rare manifestations in adults with sickle cell beta-thalassemia. Due to the lack of a clear demarcation between the complications related to sickle cell disease (SCD) and TTP, the diagnosis is often challenging. The treatment requirements for both these entities are divergent and complicated, thus necessitating a careful plan of action during atypical presentations. Here we present a case of a 22-year-old woman during the peripartum period with fever, generalized body aches, and large joint pains that soon evolved into labor. The patient's history was suggestive of an undiagnosed and inherited blood disorder. The presentation of aplastic crisis-splenic sequestration during early adulthood is atypical for the SCD course in general populations. Moreover, as the patient's clinical status deteriorated with blood transfusion, the diagnosis and management of a sickle cell crisis event and TTP added to the dilemma in the presence of non-classic parvovirus infection. Though the causation of TTP due to SCD-parvovirus infection is questionable, the treatment of the baseline sickle cell crisis with the novel supportive measures resolved the underlying complications in our patient, suggesting the causal effect. As a result of this, we emphasize the importance of being vigilant about such atypical presentations to avoid delays in diagnosis and treatment of such life-threatening emergencies like TTP.

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“…The Para-Bombay phenotype is characterized by the complete or partial loss of the H antigen on the surface of red blood cells, thus resulting in the presence of anti-H antibodies in the serum which leads to a discrepancy between the forward and reverse ABO blood groups [4]. It is extremely important to determine the blood type of Para-Bombay individuals who have anti-H antibodies since they suffer from severe hemolytic reactions when given RBCs containing the H antigen [5]. In this investigation, we present a unique and infrequent case of an individual exhibiting the Para-Bombay phenotype.…”

Section: Introductionmentioning

confidence: 99%

ABO discrepancy due to the para-Bombay phenotype: a case report

2023

Journal of Men's Health

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In this study, we aimed to determine and analyze the genetic differences of the FUT1 and FUT2 genes within an individual exhibiting the Para-Bombay phenotype. Standard serological tests were conducted to analyze the ABO phenotype. The amplification of FUT1 and FUT2 genes was conducted by polymerase chain reaction and amplicons were sequenced. The determination of the ABO genotype was conducted by sequencing exons 1 to 7 of the ABO gene. The Lewis phenotype was defined as Le(a−b+); Despite this, red blood cells (RBCs) did not show signs of A, B and H antigens using the serological method utilized in this study. However, Analyses of sequencing and cloning demonstrated the existence of a FUT1 mutation at position c.658C>T and an inactive allele FUT1*01N.06 (c.551_552delAG). Genetic testing for ABO blood types was subsequently determined to be ABO*B.01/ABO*B.01 (c.297A>G; c.526C>G; c.657C>T; c.703G>A; c.796C>A; c.803G>C; c.930G>A). Heterozygosity for indel and missense mutation within the coding region of FUT1 are likely to be responsible for development of the Para-Bombay phenotype.

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Secondary Postpartum Hemorrhage Presenting With Bombay Blood Group: A Case Report

Cited by 3 publications

References 4 publications

Navigating the challenges of Bombay phenotype (O_h) and twin pregnancy; a case report and literature review

Navigating the challenges of Bombay phenotype (O_h) and twin pregnancy; a case report and literature review

Parvovirus Infection and Thrombotic Thrombocytopenic Purpura in an Adult Patient With Sickle Cell Beta-Thalassemia

ABO discrepancy due to the para-Bombay phenotype: a case report

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Secondary Postpartum Hemorrhage Presenting With Bombay Blood Group: A Case Report

Cited by 3 publications

References 4 publications

Navigating the challenges of Bombay phenotype (Oh) and twin pregnancy; a case report and literature review

Navigating the challenges of Bombay phenotype (Oh) and twin pregnancy; a case report and literature review

Parvovirus Infection and Thrombotic Thrombocytopenic Purpura in an Adult Patient With Sickle Cell Beta-Thalassemia

ABO discrepancy due to the para-Bombay phenotype: a case report

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Navigating the challenges of Bombay phenotype (O_h) and twin pregnancy; a case report and literature review

Navigating the challenges of Bombay phenotype (O_h) and twin pregnancy; a case report and literature review