BACKGROUND:

Autoimmune hemolytic anemia is characterized by lysis of erythrocytes that occurs due to immune mechanisms; it affects one in every 140,000 pregnant women. Hemolytic anemia due to warm antibodies constitutes 80% of the cases and poses risks of maternal morbidity: angina, heart failure and death. For the fetus: fetal growth restriction, preterm delivery, miscarriage or fetal death. For the neonate: hemolytic disease of the newborn. It is a very low frequency disease.

CLINICAL CASE:

19-year-old patient, 30 weeks pregnant, with a history of autoimmune hemolytic anemia due to warm antibodies, with dyspnea and palpitations. On admission to the Central Military Hospital, hemodynamic instability was documented, and hemolytic crisis was diagnosed. She was treated with boluses of methylprednisolone, then prednisone and transfusion of blood products. The pregnancy was terminated by delivery, with a low-birth-weight newborn, without signs of neonatal hemolysis and adequate maternal and perinatal outcome.

CONCLUSION:

Autoimmune hemolytic anemia due to warm antibodies is a disease of very low frequency during pregnancy that favors morbidity in the mother and fetus, due to the potential possibility of the antibodies crossing the placental barrier. Diagnosis is established by identification of hemolysis with positive antiglobulin or direct Coombs' test. Transfusion support and corticosteroids are the first line of treatment.