Hemolytic disease of newborn: Can think beyond Rh (D) and ABO incompatibilities

The widespread use of Rh-D immune globulin has led to a relative increase in the importance of non-Rh-D isoimmunization as a cause of hemolytic disease of the fetus and newborn (HDN). Disease spectrum for non-anti-D erythrocyte alloimmunization may range from subclinical hemolysis to active hemolysis and hyperbilirubinemia requiring exchange transfusion. We report such a case of HDN due to Rh anti-c in an infant of an Rh-positive mother, who required double volume exchange transfusion.