Successful treatment of a severe second trimester fetomaternal hemorrhage by repeated fetal intravascular transfusions.
OBJECTIVE
It was the aim of this study to report a case of fetomaternal hemorrhage (FMH) that was successfully treated with fetal intravascular transfusions in which the middle cerebral artery peak systolic velocity (MCA-PSV) detected fetal anemia.


METHODS
A massive FMH occurred twice in a healthy 33-year-old pregnant woman at 26 and 29 weeks of gestation with no evident cause. Four repeated intravascular transfusions were performed. The MCA-PSV increased in the presence of anemia and decreased following correction of fetal hematocrit.


RESULTS
A healthy neonate was delivered at 33 weeks of gestation.


CONCLUSIONS
MCA-PSV detected fetal anemia both before the first transfusion and following the next intravascular transfusions. In our case, the change in fetal blood viscosity following transfusion with adult blood did not affect the MCA-PSV value for detection of fetal anemia.
Votino
Carmela
C
Fetal Medicine Unit, Institut de Puériculture, Paris, France. otina@libero.it
Mirlesse
Véronique
V
Gourand
Luc
L
Parnet-Mathieu
Françoise
F
Bessières
Bettina
B
Daffos
Fernand
F
D000328:Adult; D000740:Anemia / Q000628:therapy; D001783:Blood Flow Velocity; D001805:Blood Transfusion, Intrauterine; D005260:Female; D005331:Fetomaternal Transfusion / Q000628:therapy*; D006400:Hematocrit; D006801:Humans; D007231:Infant, Newborn; D020768:Middle Cerebral Artery / Q000502:physiology; D011247:Pregnancy; D011262:Pregnancy Trimester, Second; D012720:Severity of Illness Index