After anti-D prophylaxis became routine, which maternal red cell antibody is now the MOST common cause of significant haemolytic disease of the fetus and newborn?

• A Anti-Kell (K1)
• B Anti-M
• C Anti-E
• D Anti-c (little c) ✓

Explanation

With routine anti-B prophylaxis, anti-c has become the most frequently encountered antibody causing clinically significant HDFN after anti-B itself. It behaves similarly to anti-B, causing extramedullary haematopoiesis and hydrops, and requires the same MCA Doppler surveillance. Anti-Kell causes severe anaemia largely by suppressing erythropoiesis, so fetal haemoglobin underestimates severity, while anti-M is usually cold reacting and clinically insignificant.

Reference: Robbins and Cotran Pathologic Basis of Disease, 10th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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