Document Detail


Doppler sonography of the fetal middle cerebral artery in the management of massive fetomaternal hemorrhage.
MedLine Citation:
PMID:  16757907     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Massive fetomaternal hemorrhage (FMH) is a rare complication in pregnancy that may cause hydrops or can even be life-threatening for the fetus. We report on the case of a 19-year-old gravida I, para 0, who presented to our clinic at 32 weeks of gestation due to decreased fetal movements. The initial fetal heart rate tracing at admission showed a sinusoidal pattern without decelerations. The ultrasound examination performed immediately described a normally developed fetus with normal amounts of amniotic fluid and without abnormities of the placental structure. Doppler sonography of the fetal middle cerebral artery gave rise to the strong suspicion of fetal anemia, so that a cordocentesis was prepared for potential intrauterine blood transfusion. Meanwhile, the rate of fetal hemoglobin (HbF) cells in the maternal blood was found to be markedly increased with 66 per thousand. Correspondingly, cardiotocographic findings worsened with repeated decelerations, thus an immediate cesarean section was performed based on the suspected diagnosis of an acute FMH. A fetus weighing 1,860 g was delivered, who had severe anemia with hemoglobin level of 4.0 g/dl. After a direct blood transfusion, HbF levels normalized rapidly, the fetus stabilized, and a normal recovery has thus far been reported. The presented case demonstrates the successful and straightforward diagnosis, as well as the management of a case of severe FMH and illustrates the special value of Doppler sonography in this context.
Authors:
M Eichbaum; A S Gast; C Sohn
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Fetal diagnosis and therapy     Volume:  21     ISSN:  1015-3837     ISO Abbreviation:  Fetal. Diagn. Ther.     Publication Date:  2006  
Date Detail:
Created Date:  2006-06-07     Completed Date:  2006-10-26     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9107463     Medline TA:  Fetal Diagn Ther     Country:  Switzerland    
Other Details:
Languages:  eng     Pagination:  334-8     Citation Subset:  IM    
Copyright Information:
Copyright (c) 2006 S. Karger AG, Basel.
Affiliation:
University of Heidelberg Medical School, Department of Gynecology and Obstetrics, Heidelberg, Germany. Michael_Eichbaum@med.uni-heidelberg.de
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MeSH Terms
Descriptor/Qualifier:
Adult
Female
Fetomaternal Transfusion / therapy,  ultrasonography*
Heart Rate, Fetal
Humans
Middle Cerebral Artery / ultrasonography*
Pregnancy
Ultrasonography, Doppler*
Ultrasonography, Prenatal*

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