Document Detail

Three cases of massive fetomaternal hemorrhage presenting without clinical suspicion.
MedLine Citation:
PMID:  15043456     Owner:  NLM     Status:  MEDLINE    
Fetomaternal hemorrhage (FMH) is a common obstetrical occurrence most often associated with small volumes of blood transferred across the placenta. Fetomaternal hemorrhage leads to alloimmunization of Rh D-negative mothers, resulting in an increased risk of hemolytic disease of the newborn. Massive FMH involving volumes of blood greater than 30 mL can cause substantial fetal morbidity and mortality. Massive FMH may present with signs and symptoms such as decreased movement, sinusoidal heart rhythms, or fetal anomalies. We present 3 cases of clinically unexpected massive FMH of 206, 88, and 155 mL. The treating clinicians were unaware of any fetal or maternal signs or symptoms of FMH until contacted by the laboratory. These cases illustrate the necessity for FMH quantitation, even in the absence of clinical suspicion. Additional studies are needed to find better ways to identify these patients in advance. Development of criteria allowing identification of patients at risk would be of benefit to both mother and baby.
Sam Pourbabak; Chad R Rund; Kendall P Crookston
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Archives of pathology & laboratory medicine     Volume:  128     ISSN:  1543-2165     ISO Abbreviation:  Arch. Pathol. Lab. Med.     Publication Date:  2004 Apr 
Date Detail:
Created Date:  2004-03-26     Completed Date:  2004-07-19     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  7607091     Medline TA:  Arch Pathol Lab Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  463-5     Citation Subset:  AIM; IM    
Department of Internal Medicine, University of New Mexico School of Medicine, Albuquerque 87131, USA.
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MeSH Terms
Anemia / congenital,  therapy
Blood Grouping and Crossmatching / methods
Blood Transfusion
Fetal Blood / immunology
Fetomaternal Transfusion / complications,  diagnosis*,  immunology
Flow Cytometry
Immunoglobulins, Intravenous / therapeutic use
Infant, Newborn
Rh Isoimmunization / etiology*,  prevention & control
Rh-Hr Blood-Group System / genetics,  immunology
Rho(D) Immune Globulin / therapeutic use
Reg. No./Substance:
0/Immunoglobulins, Intravenous; 0/Rh-Hr Blood-Group System; 0/Rho(D) Immune Globulin; 0/Rho(D) antigen

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