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Severe hemolytic disease of the newborn due to anti-Cw.

BACKGROUND: Pregnancies complicated by Rh isoimmunization have decreased significantly since the widespread use of Rh immune globulin. Uncommon red blood cell antigens have therefore become more clinically evident. We report a case of anti-Cw immunization that resulted in severe fetal anemia that required multiple transfusions.

CASE: A 28-year-old multigravida presented to our service at 18 weeks of gestation with her fourth pregnancy. Her pregnancy was complicated by anti-Cw isoimmunization that resulted in severe fetal anemia requiring in utero fetal blood transfusions.

CONCLUSION: While previous reports recommend only postpartum surveillance when Cw isoimmunization is present, we report a case resulting in severe fetal anemia.

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