Document Detail


Fetomaternal hemorrhage.
MedLine Citation:
PMID:  20410781     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Fetomaternal hemorrhage refers to the entry of fetal blood into the maternal circulation before or during delivery. Antenatal fetomaternal hemorrhage is a pathological condition with a wide spectrum of clinical variation. Secondary to the resultant anemia, fetomaternal hemorrhage may have devastating consequences for the fetus such as neurologic injury, stillbirth, or neonatal death. Presentation is frequently without an evident precipitating factor. Recognition may become apparent only after injury has occurred, if at all. The most common antenatal presentation is decreased fetal activity and a heightened index of suspicion is warranted in cases of persistent maternal perception of decreased fetal movements. The diagnostic standard, the Kleihauer-Betke screen, has several limitations. Management remains challenging. When detected antenatally, cordocentesis with intrauterine transfusion may be attempted to correct the anemia; however, repeat intrauterine transfusion or delivery may be necessitated to correct ongoing bleeding. Although the occurrence of large antenatal fetomaternal hemorrhage is fortunately rare, this entity likely remains underreported and underrecognized. A national registry should be created to advance our learning across institutions by reviewing the clinical presentations of fetomaternal hemorrhage, the variety of fetal heart rate tracings observed, the management strategies undertaken, and the outcomes achieved.
Authors:
Blair J Wylie; Mary E D'Alton
Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Obstetrics and gynecology     Volume:  115     ISSN:  1873-233X     ISO Abbreviation:  Obstet Gynecol     Publication Date:  2010 May 
Date Detail:
Created Date:  2010-04-22     Completed Date:  2010-05-18     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0401101     Medline TA:  Obstet Gynecol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1039-51     Citation Subset:  AIM; IM    
Affiliation:
Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Massachusetts General Hospital, Boston, Massachusetts, USA. bwylie@partners.org
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MeSH Terms
Descriptor/Qualifier:
Animals
Female
Fetomaternal Transfusion* / diagnosis,  physiopathology,  therapy
Flow Cytometry
Humans
Pregnancy
Pregnancy Outcome
Prognosis

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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