28. Fetal - maternal hemorrhage: A comparison of two cases
Main Article Content
Abstract
Almost all pregnancies have only a small amount of fetal blood in maternal circulation. In some rare cases, massive fetal-maternal hemorrhage can result in rapid fetal hemodynamic collapse, leading to severe fetal morbidity and mortality. Unfortunately, fetal – maternal hemorrhage is rarely diagnosed prenatally because clinical manifestations are often nonspecific, subtle, and difficult to identify at the time of the event. In this article, we present two cases of large fetal-maternal hemorrhage which were proven by the Kleihaure-Betke test to highlight the difference between nonspecific initial manifestations and the outcome of each case. Moreover, we would like to emphasize the importance of early detection and timely treatment to prevent potentially devastating complications of this condition.
Article Details
Keywords
Fetal-maternal hemorrhage (FMH), neonatal anemia, Kleihaure-Betke (KB) test.
References
2. Carles D, André G, Pelluard F, Martin O, Sauvestre F. Pathological Findings in Feto-maternal Hemorrhage. Pediatr Dev Pathol. 2014; 17(2): 102-106.
3. Solomonia N, Playforth K, Reynolds EW. Fetal-maternal hemorrhage: a case and literature review. AJP Rep. 2012; 2(1): 7-14.
4. Wiener AS. Diagnosis and treatment of anemia of the newborn caused by occult placental hemorrhage. Am J Obstet Gynecol. 1948; 56(4): 717-722.
5. Chown B. Anaemia from bleeding of the fetus into the mother’s circulation. Lancet. 1954; 266(6824): 1213-1215.
6. Miyahara J, Sugiura H, Ohki S. Survival of an infant with massive fetomaternal hemorrhage with a neonatal hemoglobin concentration of 1.2 g/dL without evident neurodevelopmental sequelae. SAGE Open Medical Case Reports. 2020; 8:2050313X20941984.
7. Smet C, Queiró L, Santos E, Reis A, Costa C. Massive fetomaternal hemorrhage: a case series and review of literature. Case Reports in Perinatal Medicine. 2022; 11(1).
8. Pourbabak S, Rund CR, Crookston KP. Three Cases of Massive Fetomaternal Hemorrhage Presenting Without Clinical Suspicion. Archives of Pathology & Laboratory Medicine. 2004; 128(4): 463-465.
9. Troìa L, Al-Kouatly HB, McCurdy R, Konchak PS, Weiner S, Berghella V. The Recurrence Risk of Fetomaternal Hemorrhage. Fetal Diagn Ther. 2019; 45(1): 1-12.
10. Krywko DM, Yarrarapu SNS, Shunkwiler SM. Kleihauer Betke Test. In: StatPearls. StatPearls Publishing; 2023. Accessed May 6, 2023. http://www.ncbi.nlm.nih.gov/books/NBK430876/.
11. Giacoia GP. Severe fetomaternal hemorrhage: a review. Obstet Gynecol Surv. 1997; 52(6): 372-380.
12. Holton ME. Unexpected anemia in a newborn. Tex Med. 1989; 85(2): 50-51.
13. Carr NR, Henry E, Bahr TM, et al. Fetomaternal hemorrhage: Evidence from a multihospital healthcare system that up to 40% of severe cases are missed. Transfusion. 2022; 62(1): 60-70.
14. Solomonia N, Playforth K, Reynolds EW. Fetal-Maternal Hemorrhage: A Case and Literature Review. AJP Rep. 2012; 2(1): 7-14.
15. Espinosa A, Finserås K, Storvold G, et al. A Case of Severe, Silent Fetomaternal Haemorrhage (FMH) Detected by Mixed-Field in the Mother’s ABO Typing. Journal of Gynecological Research and Obstetrics. 2016; 2(1): 061-062.