Abstract
Introduction: Anti-Kpa antibodies are an uncommon cause of hemolytic disease of the fetus and newborn (HDFN). Screening for antibodies to low frequency antigens such as Kpa is not routine, so detecting them can present a challenge. Case Report: We report a case of hydropic HDFN due to anti-Kpa antibodies discovered incidentally with direct antiglobulin testing of a fetal blood sample in the course of work-up and treatment for presumed acute parvovirus B19 induced hydrops fetalis. Six intrauterine red blood cell transfusions and one simple neonatal red blood cell transfusion were required. Conclusion: The cause of fetal anemia needs to be properly diagnosed in order to provide appropriate clinical care in affected pregnancies. Sensitization from uncommon antigens is more difficult to diagnose due to the lack of routine screening. This case illustrates the importance of performing direct antiglobulin testing on fetal blood before intrauterine transfusion in any case of fetal anemia despite presumed alternative etiologies.
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