1/7. The importance of simple microscopy.A case of severe neonatal anaemia, the cause of which was found to be severe fetomaternal haemorrhage is presented. The diagnosis was confirmed by simple microscopic examination of the maternal blood using the technique of acid elution, the Kleihauer-Betke test. In the differential diagnosis of anaemia of a newborn, the diagnosis of fetomaternal haemorrhage must be considered and the simple Kleihauer-Betke test should be performed on the maternal blood as soon as possible.- - - - - - - - - - ranking = 1keywords = anaemia (Clic here for more details about this article) |
2/7. Occult fetomaternal haemorrhage as a cause of fetal mortality and morbidity.Spontaneous fetomaternal haemorrhage is an important, but usually overlooked, cause of perinatal mortality and morbidity. Although fetomaternal bleeding in the third trimester of pregnancy is common it is normally less than 0.1 ml. A fetal macrotransfusion (greater than 5 ml) is uncommon, but is important because it is insidious, unexpected and usually occurs in completely normal pregnancies. This paper analyses the perinatal mortality and morbidity associated with occult fetomaternal haemorrhage at the Royal women's Hospital, Melbourne. It may lead to fetal distress before and during labour, unexplained stillbirth, or nonhaemolytic neonatal anaemia. A Kleihauer test on maternal blood will readily detect fetomaternal bleeding, and we describe a simple way of calculating the absolute volume of fetal red cells present. Greater awareness of the problem may eventually lead to diagnosis sufficiently early to permit effective treatment.- - - - - - - - - - ranking = 0.5keywords = anaemia (Clic here for more details about this article) |
3/7. Chorioangioma placentae and feto-maternal transfusion; a report of two cases.Chorioangioma (CA) is found in about 1% of all placentas. Here we report cases of CA: one associated with intra-uterine fetal death, and the other with feto-maternal transfusion resulting in severe anaemia of the child. Feto-maternal transfusion through a CA could, in suspected cases, be diagnosed by s-AFP, one-minute alkali-denaturation test and perhaps ultrasound of the placenta. Intra-uterine death of the child could then be prevented by Caesarean section.- - - - - - - - - - ranking = 0.5keywords = anaemia (Clic here for more details about this article) |
4/7. Sinusoidal antenatal fetal heart rate patterns.The sinusoidal fetal heart rate pattern is significantly associated with severe fetal anaemia when seen in the antenatal period. Strict adherence to definition is important, as pseudosinusoidal patterns do not have the same grave prognostic significance. If this fetal heart rate pattern is seen antenatally it is our contention that the baby should be delivered urgently by Caesarean section, unless the fetal anaemia can be treated in utero.- - - - - - - - - - ranking = 1keywords = anaemia (Clic here for more details about this article) |
5/7. Feto-maternal haemorrhage as a cause of fetal morbidity and mortality.Massive feto-maternal haemorrhage is a cause of significant fetal morbidity and mortality, but is often overlooked because screening for fetal erythrocytes in the maternal circulation has not been a routine procedure in stillbirths, fetal distress or neonatal anaemia; there are few recognized clinical symptoms or signs, or histopathological features. This report covers three cases. A screening blood test in the last month of pregnancy could be of value in detecting feto-maternal haemorrhage before irreversible damage to the fetus occurs.- - - - - - - - - - ranking = 0.5keywords = anaemia (Clic here for more details about this article) |
6/7. Fetomaternal haemorrhage discovered after trauma and treated by fetal intravascular transfusion.Fetomaternal haemorrhage can occur spontaneously, or after abdominal trauma. We describe a case of fetomaternal haemorrhage diagnosed at 27 weeks gestation after blunt trauma. The Kleihauer-Betke smear on admission and during the first week was positive, ranging between 3% and 5%. cordocentesis revealed a fetal haemoglobin of 8.8 gm/dl. An intravascular fetal transfusion was performed. The weeks until delivery and the neonatal period were unremarkable. Fetal anaemia can be a serious complication of fetomaternal haemorrhage, however, intravascular fetal transfusion is an effective treatment when this occurs. The Kleihauer-Betke test should be performed in every patient with a history of abdominal trauma during pregnancy.- - - - - - - - - - ranking = 0.5keywords = anaemia (Clic here for more details about this article) |
7/7. Fetomaternal haemorrhage and prenatal intracranial bleeding: two more causes of blueberry muffin baby.Blueberry muffin lesions are associated with prenatal infections, severe and chronic anemia and neoplastic infiltrative diseases. In the first two instances they represent postnatal re-expression of cutaneous haematopoiesis, in the latter they are cutaneous localizations of a neoplastic disease. Chronic prenatal anaemia leading to blueberry muffin lesions in the neonate has been reported in association with severe haemolytic anaemia such as congenital spherocytosis, Rhesus haemolytic disease and ABO incompatibility, or in anaemia caused by twin-to-twin transfusion. We present two more causes of prenatal anaemia leading to blueberry muffin lesions: chronic fetomaternal haemorrhage and severe intracranial bleeding. CONCLUSION: In any blueberry muffin baby with profound anaemia, chronic fetomaternal haemorrhage and severe internal bleeding should be included in the differential diagnosis. skin biopsy must be performed to rule out neoplastic infiltrative diseases.- - - - - - - - - - ranking = 2.5keywords = anaemia (Clic here for more details about this article) |