title: Massive fetomaternal hemorrhage treated with serial combined intravascular and intraperitoneal fetal transfusions.
abstract: One of the many causes of fetal hydrops is fetomaternal hemorrhage. This report presents a pregnancy with fetomaternal hemorrhage that was treated with serial combined intravascular and intraperitoneal fetal transfusions, resulting in a good outcome. A 26-year-old woman seen for ultrasonographic evaluation was found to have a fetus with hydrops fetalis. Fetal blood sampling demonstrated severe fetal anemia (hematocrit 16.4%). The initial Kleihauer-Betke test result on maternal blood was 6% fetal cells. The fetus was transfused five times over a 24-day period by means of a combined intravascular and intraperitoneal route. The fetus also received one platelet transfusion for thrombocytopenia. The pregnancy resulted in a good fetal outcome without the need for postpartum transfusion. This case represents successful treatment of fetal anemia and nonimmune hydrops with a serial combined intravascular and intraperitoneal transfusion technique.
authors.affiliation: Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, TX 77030, USA.
authors.forename: L D
authors.initials: LD
authors.lastname: Montgomery
authors.forename: M A
authors.initials: MA
authors.lastname: Belfort
authors.forename: K
authors.initials: K
authors.lastname: Adam
mesh_terms: D000328:Adult; D001805:Blood Transfusion, Intrauterine / Q000379:methods*; D005260:Female; D005331:Fetomaternal Transfusion / Q000628:therapy*; D006801:Humans; D015160:Hydrops Fetalis / Q000150:complications; D011247:Pregnancy