title: Massive feto-maternal hemorrhage: diagnosis by cardiotocography, Doppler ultrasonography and ST waveform analysis of fetal electrocardiography.
abstract: A 34-year-old healthy gravida 2 para 1 presented after an uncomplicated pregnancy at term with a 2-day history of diminished fetal movements. Fetal anemia was suspected by fetal heart rate monitoring and Doppler estimation of the fetal peak blood flow velocity of the middle cerebral artery. We were also fortunate to register pathological ST waveform changes of the fetal ECG indicating fetal hypoxia. The diagnosis of a massive feto-maternal hemorrhage was confirmed by an extremely high fraction of erythrocytes containing fetal hemoglobin in maternal blood and, after delivery, by placental histology.
authors.affiliation: Department of Obstetrics and Gynecology, University Hospital, Lund, Sweden. peter.malcus@med.lu.se
authors.forename: Peter
authors.initials: P
authors.lastname: Malcus
authors.forename: Lars J
authors.initials: LJ
authors.lastname: Bjorklund
authors.forename: Monica
authors.initials: M
authors.lastname: Lilja
authors.forename: Pia
authors.initials: P
authors.lastname: Teleman
authors.forename: Ricardo
authors.initials: R
authors.lastname: Laurini
mesh_terms: D000328:Adult; D015148:Cardiotocography; D004562:Electrocardiography; D005260:Female; D005331:Fetomaternal Transfusion / Q000175:diagnosis* / Q000000981:diagnostic imaging; D006340:Heart Rate, Fetal; D006801:Humans; D007231:Infant, Newborn; D011247:Pregnancy; D011296:Prenatal Diagnosis / Q000379:methods*; D018608:Ultrasonography, Doppler; D016216:Ultrasonography, Prenatal