The Recurrence Risk of Fetomaternal Hemorrhage

Abstract

Massive fetomaternal hemorrhage (FMH) can cause devastating pregnancy outcomes. Perinatal prognosis may be improved by intrauterine transfusion, but the appropriate management for these pregnancies remains unclear. To determine the recurrence risk of FMH after intrauterine transfusion, we performed a systematic review of all case reports/series of patients with proven FMH treated with intrauterine transfusion and who had subsequent follow-up of at least 72 h until delivery. This revealed 13 cases, with 1 additional case from our institution. Ten patients (71.4%) had a second episode of FMH requiring a second intrauterine transfusion. Five patients (35.7%) required at least 3 intrauterine transfusions. The time interval between intrauterine transfusions was progressively reduced. The gestational age at the onset of signs/symptoms was 26.6 ± 2.1 weeks, and gestational age at delivery was 34.2 ± 4.2 weeks. Two cases of fetal demise (14.3%) and no neonatal deaths were recorded. Limited postnatal follow-up on 8 neonates was normal. The mean neonatal hemoglobin and transfusion rates were 13.2 ± 5.7 g/dL and 33.3%, respectively. Close fetal monitoring, likely daily, is necessary to recognize FMH recurrence. Several transfusions may be necessary once FMH is diagnosed if pregnancy is allowed to continue > 72 h.

High diagnosis rate for nonimmune hydrops fetalis with prenatal clinical exome from the Hydrops-Yielding Diagnostic Results of Prenatal Sequencing (HYDROPS) Study

“…Notably, fetomaternal hemorrhage, a known nongenetic etiology of NIHF, was not mentioned as an exclusion criterion in their study. 26 Another unique aspect of our study is that only trios were enrolled. All these reasons likely account for our trend toward a higher diagnostic rate.…”

Are Twin Pregnancies Complicated by Weight Discordance or Fetal Growth Restriction at Higher Risk of Preeclampsia?

“…However, monochorionic twin pregnancies seem to be less affected by hypertensive complications compared to dichorionic ones [ 2 ]. This might be due to a lower gestational age at delivery in monochorionic twins [ 31 ] and to a lower circulating blood volume in monochorionic twin pregnancies (single fetal-placental unit) with a subsequent better cardiovascular adaptation to the pregnancy compared to dichorionic twins (double fetal-placental unit) [ 32 ]. However, more studies are necessary to elucidate the differences between the two groups and to explain the pathogenesis of HDP in each group.…”

A Silicon-based Coral-like Nanostructured Microfluidics to Isolate Rare Cells in Human Circulation: Validation by SK-BR-3 Cancer Cell Line and Its Utility in Circulating Fetal Nucleated Red Blood Cells

“…However, it should be highlighted that any cbNIPD platforms must be able to demonstrate its feasibility through prospective, double-blinded, large-scale clinical trials to convince the clinical communities, hopefully in the near future, that indeed it is a workable solution and can then compete with the now very successful cffDNA NIPT. It can also be anticipated that new confounding factors may affect the accuracy of cbNIPD theoretically, such as fetomaternal hemorrhage, a not uncommon complication during the gestation [44].…”