Massive foetomaternal haemorrhage resulting in severe neonatal anaemia

A case of massive foetomaternal haemorrhage [FMH] is presented which resulted in diminished foetal movements and severe neonatal anaemia. An emergency caesarian section was performed in a 37 weeks pregnant woman with poor foetal activity and non-reactive foetal heart rate of unexplained etiology. A baby boy with severe anaemia [Hb 5.7 g/dl] having no signs of haemolysis was delivered. The blood film of the baby showed normoblastaemia and reticulocytosis. Kliehaur test on mother revealed 4% foetal red cells, confirming massive FMH. The baby required repeated packed red cell transfusions during his stay in the hospital. He was discharged symptom free with a Hb of 13.4 g/dl. In this case the baby had a good clinical course. Early diagnosis and prompt intervention are mandatory in cases of massive FMH for good prognosis

Study of foetomaternal haemorrhage in relation to mode of delivery.

A study on 100 pregnant women regarding foetomaternal haemorrhage (FMH) in relation to mode of delivery with Kleihauer acid-elution technique revealed that FMH was affected by mode of delivery. Incidence of FMH was nil in normal spontaneous delivery without syntocinon drip but the incidence of FMH in normal delivery preceded by syntocinon drip was 19.05%, in forceps delivery 40%, in lower uterine caesarean section 50% and in normal delivery followed by manual removal of placenta 100%. The incidence of FMH was more in postpartum period (16%) than that in antenatal period (8%).