[Anaemia in two infants due to fetomaternal transfusion]. / Anemie bij 2 zuigelingen door foetomaternale transfusie.

In two neonates, a boy suffering from persistent pulmonary hypertension of the newborn and a girl with fetal distress, massive fetomaternal haemorrhage was diagnosed (290 ml). In both cases fetal monitoring showed a sinusoidal heart rate pattern and the Kleihauer-Betke test was positive. Both children were intubated and ventilated and were given an erythrocyte transfusion. They both recovered. Differentiation between acute and chronic fetomaternal haemorrhage is essential when deciding on treatment: blood transfusion in acute fetomaternal haemorrhage and exchange transfusion in chronic fetomaternal haemorrhage with normoor hypervolemia. Differentiation is difficult. Little is known about the prognosis of fetomaternal haemorrhage. Because of the nature of perinatal problems and the possibility of neurological damage, long-term follow-up is recommended.

[General knowledge of the performance of Mantoux-test procedure deemed inadequate]. / Parate kennis over de uitvoering van de Mantoux-test onvoldoende.

OBJECTIVE: To investigate whether health care professionals have sufficient knowledge of the Mantoux test procedure. DESIGN: Descriptive. METHODS: The hospital pharmacy records of the Medisch Spectrum Twente, a large teaching hospital in Enschede (1034 beds), the Netherlands, were reviewed to determine which departments had performed Mantoux tests in 1996. The municipal health service and the industrial/occupational medicine department of the hospital were included in the investigation. Knowledge of the Mantoux test procedure was assessed in 44 randomly chosen health care professionals by means of a multiple-choice questionnaire. They were also asked how often they had performed Mantoux tests in 1996 and whether they thought themselves able to perform the total Mantoux test procedure correctly. RESULTS: The frequency of setting and/or reading the Mantoux test was generally low and varied per department. Ninety-three percent of the 44 subjects under investigation presumed themselves able to perform the Mantoux test correctly. From the questionnaire forty percent knew how to set a Mantoux test, while 15 of the 33 persons (45%) who had read a Mantoux reaction knew how to do this correctly. Nine of these 33 (27%) had sufficient knowledge to execute the whole Mantoux test procedure correctly. The knowledge of the correct Mantoux test procedure was significantly better among those who performed the Mantoux test more often. CONCLUSION: The theoretical knowledge regarding the Mantoux test is insufficient, especially among those health care professionals who rarely perform the test. It appears advisable to have the Mantoux tests performed by a few well-trained professionals.