A pilot prospective study of fetomaternal hemorrhage identified by anemia in asymptomatic neonates

Stroustrup, Annemarie; Plafkin, Callie

doi:10.1038/jp.2015.211

Cited by 7 publications

(9 citation statements)

References 22 publications

(31 reference statements)

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“…The majority of these studies likely used a combination of Rhþ and Rh-negative females, as only 3 (19%) of these studies actually defined the number of Rhþ females evaluated. [22][23][24] These studies also predominantly used fetal cell positivity (ie, any fetal cells detected) as the predictor of interest (only 1 of 16 used the predicted percentage of fetal bleed). 23 Given these caveats, we found that only 3 (19%) of the 16 studies identified the KB test as predictive of adverse fetal outcomes.…”

Section: Supplemental Questions Appended To College Of Americanmentioning

confidence: 99%

“…Of the remaining studies, 8 found no association between the KB test and preterm delivery or labor, 24,26-32 8 found no association with placental abruption, 26,28-34 5 found no association with fetal mortality, 24,30-32,35 and 3 found no association with neonatal anemia. 22,35,36 Taken together, the current literature is at best not conclusive, and the significance of the KB test result and its utility as a predictor for fetal outcomes is questionable.…”

Section: Supplemental Questions Appended To College Of Americanmentioning

confidence: 99%

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Use of Fetal Hemoglobin Quantitation for Rh-Positive Pregnant Females: A National Survey and Review of the Literature

Karafin

Glisch

Souers

et al. 2019

Archives of Pathology &Amp; Laboratory Medicine

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Context.— The Kleihauer-Betke (KB) test is validated for estimating the dose of Rh immune globulin needed for Rh-negative pregnant females. However, some clinicians are also ordering the test for Rh-positive women. The degree to which this practice occurs is unknown. Objective.— To evaluate the number of laboratories that perform the KB test on Rh-positive pregnant women, and to establish current ordering practices for this indication. Design.— We added 9 supplemental questions regarding KB test use for fetomaternal hemorrhage to the 2016 College of American Pathologists proficiency test survey. We also reviewed the available literature regarding the diagnostic utility of the KB test for Rh-positive women. Results.— A total of 1578 surveys were evaluated and revealed that 52% (824) of respondents perform these tests for Rh-positive women, and more than 50% (440 of 819; 53.7%) of these laboratories report that the results for Rh-positive women are treated as important or very important. Conclusions.— The KB test is commonly used for Rh-positive women, and the information obtained from the test is considered as urgent and important. However, the available literature in support of this practice is still nonconclusive.

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Section: Supplemental Questions Appended To College Of Americanmentioning

confidence: 99%

Section: Supplemental Questions Appended To College Of Americanmentioning

confidence: 99%

Use of Fetal Hemoglobin Quantitation for Rh-Positive Pregnant Females: A National Survey and Review of the Literature

Karafin

Glisch

Souers

et al. 2019

Archives of Pathology &Amp; Laboratory Medicine

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“…Causes of increased loss of fetal blood into the maternal circulation are seen as a result of trauma, placental abruption, or may be spontaneous and idiopathic. Manifestations of fetal-maternal hemorrhage depend on the amount and the rapidity of blood loss [28]. TTTS is a rare complication of monochorionic twins (or higher multiple gestations).…”

Section: Perinatal Risk Factorsmentioning

confidence: 99%

Iron Deficiency Anemia in Children

Roganović¹,

Starinac²

2018

Current Topics in Anemia

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Iron deficiency and iron deficiency anemia remain a major and global public health problem that affects particularly infants, young children, and women of childbearing age in developing countries. The prevalence of iron deficiency anemia is still common in industrialized countries despite efforts to improve public awareness and strengthen programs for the prevention and control of iron deficiency. The most common risk factors for iron deficiency in early childhood are rapid growth, perinatal risk factors, poor dietary intake, and gastrointestinal blood loss due to excessive consumption of cow's milk. Iron deficiency and iron deficiency anemia cause a wide variety of symptoms and changes in many different tissues. The most concerning consequences of iron deficiency in children are the alterations of cognitive, motor, and behavioral performance. Persistent neurocognitive changes despite iron repletion have increased the importance of prevention and early detection of iron deficiency. The main principles of treatment include investigation and elimination of the underlying cause, iron supplementation, improvement of nutrition, and education of the patient and family. Oral iron supplements are desirable as first-line therapy. Follow-up is very important to confirm the diagnosis and to ensure that anemia is adequately treated.

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“…1,9 Nos casos de hemorragia prolongada durante a gravidez, a anemia progride lentamente, dando ao feto a possibilidade de desenvolver mecanismos compensató-rios de hematopoiese fetal e regulação do volume intravascular. 11 O diagnóstico é frequentemente pós-natal e estes RN podem apresentar-se com palidez cutânea como única manifestação. 1 Os sintomas iniciais da HFM aguda são muitas vezes subtis e inespecíficos.…”

Section: 367unclassified

Hemorragia feto-materna grave como causa de encefalopatia hipóxico-isquémica

Ferreira

Coutinho

Teixeira

et al. 2018

Acta Pediátrica Port

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A hemorragia feto-materna é a passagem de sangue fetal para a circulação materna e ocorre na maioria das gestações de forma insignificante. Quando a hemorragia é acentuada, pode associar-se a morbimortalidade fetal e neonatal importante. Apresenta--se o caso clínico de um recém-nascido de termo, sexo feminino, de gravidez sem intercorrências até dois dias antes do parto, quando a grávida notou diminuição dos movimentos fetais, tendo sido realizada cesariana emergente no dia da admissão no serviço de urgência, por sofrimento fetal agudo. O recém-nascido apresentou-se pálido, verificando-se posteriormente, anemia acentuada (hemoglobina 2,9 g/dL), choque hipovolémico e encefalopatia hipoxico-isquémica. Perante uma anemia neonatal grave e excluídas as hipóteses de hemólise e descolamento de placenta, evocou-se o diagnóstico de hemorragia feto-materna, confirmado por citometria de fluxo (7,9% de hemoglobina fetal no sangue materno). Os autores pretendem realçar que apesar da hemorragia feto-materna grave ser uma causa rara de anemia neonatal, pode manifestar-se como sofrimento fetal agudo, com morbilidade significativa.Palavras-chave: Anemia, Neonatal; Complicações na Gravidez; Hipoxia-Isquemia Encefálica; Recém-Nascido; Sofrimento Fetal; Transfusão Feto-Materna AbstractFetomaternal haemorrhage consists in the transmission of fetal blood to the mother's bloodstream. It occurs in most pregnancies with no apparent clinical significance. However, large volumes of fetomaternal haemorrhage can be associated with important fetal and neonatal morbidity and mortality. The authors report the case of a term female newborn, from a pregnancy that was uneventful until two days before delivery, when the mother noticed a decrease in fetal movements. Acute fetal distress was confirmed on the day of admission to the emergency department and an emergent caesarean section was performed. The newborn presented very pale, with severe anaemia (haemoglobin 2.9 g/dL), hypovolemic shock and hypoxic-ischaemic encephalopathy. Haemolysis and placental abruption were ruled out and a diagnosis of fetomaternal haemorrhage was made, confirmed by flow cytometry revealing 7.9% of fetal haemoglobin in the maternal blood. The authors emphasise that although severe fetomaternal haemorrhage is a rare cause of neonatal anaemia, this condition may present as acute fetal distress with significant morbidity.Keywords: Anaemia, Neonatal; Fetal Distress; Fetomaternal Transfusion; Hypoxia-Ischaemia, Brain; Infant, Newborn; Pregnancy Complications IntroduçãoA hemorragia feto-materna (HFM) é a transferência de sangue fetal para a circulação materna antes ou durante o parto.1-3 Ocorre em quase todas as gestações em pequenos volumes (inferiores a 1 mL), sem tradução clí-nica fetal ou materna.4-6 Contudo, a transfusão de mais de 30 mL pode associar-se a morbimortalidade fetal e neonatal. 4,7A maioria dos casos de HFM é de etiologia desconhecida, espontânea e envolve, predominantemente, gestações não complicadas, perto do termo. 1,3,7As manifestações clínicas são variá...

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A pilot prospective study of fetomaternal hemorrhage identified by anemia in asymptomatic neonates

Cited by 7 publications

References 22 publications

Use of Fetal Hemoglobin Quantitation for Rh-Positive Pregnant Females: A National Survey and Review of the Literature

Use of Fetal Hemoglobin Quantitation for Rh-Positive Pregnant Females: A National Survey and Review of the Literature

Iron Deficiency Anemia in Children

Hemorragia feto-materna grave como causa de encefalopatia hipóxico-isquémica

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