Risk related to the presence of erythrocyte autoantibodies during pregnancy.

Introduction. - Red cell autoantibodies are very rarely observed in pregnan t women. We report one case related to the presence of a lupus anticoagulan t. Exegesis. - A 32-year-old woman had a history of two intrauterine deaths th at had occur-led at weeks 32 and 33, respectively Due to the presence of a lupus anticoagulant, prednisone (20 mg/day) and subcutaneous calcium hepari n were administered during her third pregnancy. The direct antiglobulin tes t remained positive throughout the pregnancy; however, hemolysis could nor be detected Caesarean section was done in emergency at week 29, due to feta l bradycardia related to severe fetal hemolysis. Conclusion. - When autoimmune hemolysis occurs during pregnancy, risks for the fetus increase with the severity of hemolysis in the mother: it is thou ght that child mortality reflects the existence of anemia, anemia, rather t han the existence of hemolysis. Our observation suggests that severe fetal hemolysis may occur despite the absence of hemolysis in the mother. (C) 199 9 Elsevier, Paris.