Severe Neonatal Anemia Due to Spontaneous Massive Fetomaternal Hemorrhage at Term: An Illustrative Case with Suspected Antenatal Diagnosis and Brief Review of Current Knowledge

Medicina

Gheorghe Peltecu¹  Nicolae Gică¹  Radu Botezatu¹  Anca Maria Panaitescu¹  Anca Marina Ciobanu¹  Brîndușa Ana Cimpoca-Raptis¹  Corina Gica¹  Ana Maria Vayna²  Mihaela Demetrian² 

[1] Carol Davila Department of Obstetrics and Gynecology, University of Medicine and Pharmacy, 020021 Bucharest, Romania;Filantropia Clinical Hospital, 011171 Bucharest, Romania;

关键词: fetomaternal hemorrhage;    fetoplacental hemorrhage;    fetomaternal bleeding;    Kleihauer–Betke test;    fetal anemia;    cardiotocography;   

DOI  :  10.3390/medicina57121285

来源: DOAJ

【 摘 要 】

Fetomaternal hemorrhage is defined as transfer of fetal blood into placental circulation and therefore into maternal circulation during pregnancy, and represents an important contributor to intrauterine fetal demise and neonatal death. The condition is rarely diagnosed prenatally because clinical findings are often nonspecific, and it is unpredictable. In this paper we present an illustrative case of massive spontaneous fetomaternal hemorrhage where the diagnosis was highly suspected antenatally based on maternal reported reduced fetal movements, abnormal suggestive cardiotocographic trace, and increased peak systolic velocity in the fetal middle cerebral artery. We discuss obstetrical and neonatal management and review the current knowledge in the literature. Maintaining a high index of suspicion for this condition allows the obstetrician to plan for adequate diagnostic tests, arrange intrauterine treatment or delivery, and prepare the neonatal team.

【 授权许可】

Unknown