Heise RH, Van Winter JT, Ogburn PL. Identification of acute transplacental hemorrhage in a low-risk patient as a result of daily counting of fetal movements.
Mayo Clin Proc 1993;
68:892-4. [PMID:
8371606 DOI:
10.1016/s0025-6196(12)60698-3]
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Abstract
In this report, we describe a case of acute, massive fetomaternal hemorrhage that was detected during the 32nd week of pregnancy by maternal perception of decreased fetal movement and suggestion of a sinusoidal heart rate pattern. Additional evaluation revealed an abnormal biophysical profile (2 of 10) and intermittent late decelerations. Because of the substantially decreased fetal reserve, cesarean section was emergently performed. A 1,880-g female infant was delivered. She had an initial hemoglobin concentration of 1.9 g/dl and a hematocrit of 5.7% but did well after appropriate transfusion therapy. This case confirms the importance of daily counting of fetal movements in low-risk patients. In addition, it emphasizes that early diagnosis and treatment of massive fetomaternal hemorrhage can improve infant survival.
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