Fetomaternal hemorrhage

Fetomaternal hemorrhage (FMH) refers to the escape of fetal blood cells into the maternal circulation. This phenomenon can occur during pregnancy, labor, or postpartum. While small amounts of FMH are common and usually harmless, larger volumes can lead to significant complications, including neonatal anemia and hydrops fetalis.

Causes

The exact cause of FMH is not fully understood, but it is believed to be associated with trauma or complications during pregnancy, such as placental abruption or uterine rupture. Other potential causes include invasive procedures like amniocentesis or cordocentesis, and conditions such as twin-to-twin transfusion syndrome.

Diagnosis

Diagnosis of FMH is often challenging due to its asymptomatic nature in most cases. However, it can be suspected in cases of unexplained fetal anemia or hydrops fetalis. The Kleihauer-Betke test is the most commonly used diagnostic test for FMH, which detects fetal hemoglobin in maternal blood.

Treatment

The treatment for FMH depends on the severity of the condition. In mild cases, no treatment may be necessary. In more severe cases, intrauterine blood transfusion may be required to treat fetal anemia. Postnatal treatment may include phototherapy for neonatal jaundice, a common complication of FMH.

Prognosis

The prognosis for FMH varies depending on the severity of the hemorrhage and the timing of diagnosis and treatment. With early detection and appropriate treatment, the prognosis can be favorable.

See also

• Rh disease
• Hemolytic disease of the newborn
• Rho(D) immune globulin

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