FETOMATERNAL HAEMORRHAGE

Fetomaternal hemorrhage: treatment by intrauterine transfusion 

Michael Permezel, MD, Lachlan De Crespigny, MD, Peter England, MB, BS 

Address for correspondence to Michael Permezel, MD, University of Melbourne, Department of Obstetrics & Gynaecology, Royal Women"s Hospital, Carlton Australia 3053. Ph: 61-3-344-2130; Fax: 61-3-347-1761 

Synonyms: Fetomaternal transfusion.

Definition:  Bleeding across the placental interface from fetus to mother.

Prevalence:  Small fetomaternal hemorrhages resulting in a positive Kleihauer‑Bethke test occur in at least 60% of pregnancies. Massive bleeds resulting in fetal death may occur in up to 4:10,000 of all births.

Management: Intrauterine trans­fu­sion or delivery.

Prognosis: If the fetus survives the initial insult, there is the possibility of long‑term neurological sequelae.

MESH Fetomaternal transfusion ICD9 656.0

Introduction

Fetomaternal hemorrhage occurs commonly in pregnancy but rarely results in fetal compromise. Kleihauer‑Bethke acid elution tests are positive in at least 60% of pregnancies with the amount of fetal red blood cells in the maternal circulation usually less than 0.1 ml¹. A more significant (0.1 ml) fetomaternal hemorrhage occurs in approximately 1% and is a potential cause of red cell isoimmunisation. Large bleeds are a cause of intrauterine death in up to 0.04% of all births².