Massive fetomaternal hemorrhage with cardiotocographic sinusoidal rhythm. A case presentation and literature review
DOI:
https://doi.org/10.18597/rcog.244Keywords:
fetomaternal transfusion, fetal heart rate, fetal blood, fetal hypoxiaAbstract
Introduction: massive fetomaternal transfusion (MFT) is an entity having high fetal morbidity and mortality; it usually involves the mother’s reduced perception of fetal movements and the presence of a cardiotocographic fetal sinusoidal rhythm, associated with fetal anemia. However, both situations have very low specificity. A clinical case is presented here to arouse interest in reviewing the precision of the sinusoidal rhythm when diagnosing fetal anemia.
Materials and methods: the case of a 36-weeks pregnant mother is presented; she attended La Paz teaching hospital (a third-level hospital forming part of the Spanish public hospital system). After presenting a non-reassuring cardiotocographic heart rate pattern, birth was induced in which the usual fetal wellbeing tests proved insufficient for diagnosing fetal suffering. The presence of serious neonatal anemia was shown following a eutocic delivery, the Kleihauer-Betke test proving the presence of a large volume of fetal blood in the mother’s blood. Articles published in both Spanish and English during the last 10 years in the Medline database were reviewed via PubMed.
Conclusion: intradelivery fetal monitoring could be useful in diagnosing massive fetal-maternal hemorrhage, even though broader studies should be carried out for determining diagnostic precision.
Author Biographies
Daniel Abehsera-Davó
Carlos Iglesias-Sánchez
Fernando Magdaleno Dans
Antonio González-González
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