Occult fetal-maternal transfusion

Fetomaternal macrotransfusion in the Yorkshire region. 2. Perinatal outcome

The perinatal outcome associated with fetomaternal macrotransfusion (FMMT), defined as fetomaternal haemorrhage greater than or equal to 10 ml, was investigated in a study group of 179 cases of FMMT and compared with the outcome in 322 controls selected from the same population. Perinatal mortality and morbidity occurred more frequently in the case group (P less than 0.01). The mean Apgar score at 1 min and the cord haemoglobin level differed significantly between the case and control groups (P less than 0.01) and showed a significant inverse correlation with the estimated volumes of FMMT (P less than 0.0001). There was no significant difference in birthweight between the case and control groups. The mean estimated volumes of FMMT associated with perinatal mortality and with low cord haemoglobin (less than or equal to 9.0 g/dl) were significantly higher than the mean volume in the case group as a whole, which suggests the possibility of adapting these observations to a screening procedure.

Massive feto-maternal hemorrhage as a cause of perinatal mortality and morbidity

11 cases of massive feto-maternal hemorrhage (FMH) detected at the Leuven Blood Transfusion Center are described. Based on these case reports, a review is given of the various theoretical and practical problems related to this complication, e.g. the relative frequency of perinatal mortality and morbidity due to massive FMH, the causes and pathogenesis, the symptoms and diagnosis, the clinical varieties, and the pathophysiology as seen in the fetus and newborn. Finally, the indications for looking for large FMHs are described, and the therapeutic implications when this complication is discovered.