Severe neonatal anemia due to acute massive fetomaternal hemorrhage - a case and literature review

S. Vlădăreanu, C. Berceanu, D. Navolan, A. Boiangiu, C. Mehedințu

Abstract: Severe and unexpected anemia at birth has a serial of potential diagnosis including hemorrhage, hemolysis and impairment production of erythrocytes. Fetomaternal hemorrhage is defined as the entrance of fetal blood intro the maternal blood stream during pregnancy, being a poorly understood condition. At birth is the most frequent time for an important fetalmaternal heamorrage to ocure. Fetomaternal bleeding may be an acute or chronic event. Important fetomaternal hemorrhage include some fetal findings like absent or persistently decreased movement, heart rate abnormality (sinusoidal fetal heart rate pattern, recurrent late decelerations, and tachycardia), low biophysical profile score, hydrops fetalis, and death. At birth can result an affected newborn similar to a neonate with a degree of intrapartum hypoxia. Physician awareness of this uncommon diagnostic is an important step in the therapeutic management. An extremely pale newborn with respiratory distress and hypovolemic shock, or an unexpected stillbirth or precocious neonatal death should raise the physician’s suspicion of this diagnostic. We report a case of an acute severe fetomaternal hemorrhage, conditions rapidly recognized and with proper neonatal reanimation resulting a favorable outcome.
DOI:10.18643/gieu.2017.13

Keywords: fetal anemia, fetomaternal hemorrhage, Kleihauer-Betke test, cardiotocograph.