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Massive Fetomaternal Hemorrhage Secondary to Intrauterine Intravascular Transfusion

Levy-Zauberman, Yaël MD; Mailloux, Agnès MD; Kane, Aminata MD; Castaigne, Vanina MD; Cortey, Anne MD; Carbonne, Bruno MD

doi: 10.1097/AOG.0b013e318212f935
Case Reports
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BACKGROUND: Small-volume fetomaternal hemorrhage is frequently observed after intrauterine transfusion. The Kleihauer-Betke test, the reference method for identifying fetomaternal hemorrhage, cannot be used after intrauterine transfusion, because the adult red blood cells used for transfusion cannot be distinguished from maternal red blood cells.

CASE: Massive fetomaternal hemorrhage secondary to intrauterine transfusion led to fetal hemorrhagic stroke. We used a method based on blood group identification in the maternal blood to confirm and to quantify fetomaternal hemorrhage.

CONCLUSION: Fetal stroke may result from severe hypovolemia and low cerebral blood flow caused by fetomaternal hemorrhage, rather than from fetal anemia itself.

Specific techniques are required to identify and quantify fetomaternal hemorrhage after intrauterine transfusion.

From the Department of Obstetrics and Gynecology and Centre National de Référence en Hémobiologie Périnatale, Hôpital Saint-Antoine, Paris, France; and Assistance Publique – Hôpitaux de Paris, Université Pierre et Marie Curie, Paris, France.

Corresponding author: Pr. Bruno Carbonne, Department of Obstetrics and Gynecology, Hôpital Saint-Antoine, 184, rue du Faubourg Saint-Antoine, 75012 Paris, France; e-mail: bruno.carbonne@sat.aphp.fr.

Financial Disclosure The authors did not report any potential conflicts of interest.

© 2011 The American College of Obstetricians and Gynecologists