Bombay Blood Type and Use of Red Cell Apheresis During Pregnancy

Background: Bombay blood type is among the rarest in the world and is associated with anti-H antibodies. These antibodies cause severe hemolysis when exposed to any blood product except Bombay and have been reported to cause hemolytic disease of the newborn.

Case: A primigravid woman with Bombay blood type received erythropoietin and underwent autologous blood donation using red cell apheresis. Maternal anti-H immunoglobulin G antibodies were identified and serial evaluation of the middle cerebral artery peak systolic velocity was used to monitor for fetal anemia. Hemolytic disease of the newborn did not develop.

Conclusion: Red cell apheresis is a valuable procedure that results in two units of red blood cells per donation and was well tolerated during pregnancy.