Abstract
Haemolytic anaemia, though uncommon, may occur in pregnancy. A rarer variant, Idiopathic haemolytic anaemia or Coomb-negative haemolytic anaemia has been described. This causes haemolysis during pregnancy and spontaneously resolves after delivery, only to recur during subsequent pregnancies, with the woman being entirely symptom-free during her non gravid state.
We encountered a clinical scenario that typifies this rare clinical presentation in a 31-year-old unbooked G5P3+1 (2A) +1 perinatal mortality referred from a private hospital at an estimated gestational age of 32 weeks +4 days.
Her clinical history and investigations were suggestive of idiopathic haemolytic anaemia of pregnancy.
She was managed with haematinics, had 4 units of blood transfused, and was commenced on glucocorticoids. She was then counseled for and had a scheduled caesarean section at EGA of 34 weeks +0D on account of concomitant fetal malpresentation and was delivered of a live male neonate with no signs of jaundice. The patient recovered with dramatic resolution of the yellowness of the eyes postpartum and was discharged on postoperative day 5 with normal indices and was discharged alongside her baby in stable condition.
The rare incidence of this clinical presentation and a favourable fetal and maternal outcome, in this case, merits its presentation.