Abstract The D−− phenotype is an extremely rare Rh blood group variant with absence of C, c, E, and e antigens but preserved D expression, predisposing to anti-Rh17 alloimmunization and hemolytic disease of fetus and newborn (HDFN). We report a 25-year-old Chinese woman (gravida 3, para 1) with D+C−c−E−e− phenotype and a history of severe neonatal jaundice and fetal demise. In her current pregnancy, admitted at 25+5 weeks for elevated fetal middle cerebral artery peak systolic velocity.
