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This is acute hemolytic transfusion reaction, I believe. Type II HSR so she’s forming antibodies against the ABO groups on the blood cells. Complement is induced by antibodies.

kfratta1  But with hypotension in the stem I thought more of anaphylaxis due to IgA def. Why would a T2 HSR give you hypotension? +1  
2ndmedschool  I think the hemoglobinuria is the key. As I’m looking at it it seems that anaphylaxis would cause hypotension, urticaria, itching, wheezing. ABO incompatibility is the only one that mentions hemoglobinuria. +2  
hyperfukus  abo incompatibility and rh incompatibility with mom blood rxns are gonna TYPE 2 no matter what it looks like +