title: Managing the difficult case of fetal anemia.
abstract: OBJECTIVE
  To describe a series of complex fetal anemia cases, detail the appropriate investigations and management, and review the literature.
  
  
  METHODS
  Four cases of non-red cell alloimmunization or infective cases of fetal anemia are presented.
  
  
  RESULTS
  Of the four cases presented, one was a neonatal death, one pregnancy was terminated, one case was diagnosed with Diamond Blackfan anemia, and one case was due to recurrent feto-maternal hemorrhages despite negative Kleihauer tests.
  
  
  CONCLUSIONS
  Non-alloimmune causes of fetal anemia can be difficult to manage. Some cases require repeated and frequent intrauterine transfusions. The perinatal mortality and preterm delivery rates are increased, and some cases require considerable long-term treatment including regular transfusions. We present our experience of a series of non-immune fetal anemia managed in a tertiary unit, review the literature, and suggest appropriate management.
authors.affiliation: Centre for Fetal and Maternal Medicine, Queen Charlotte's and Chelsea Hospital, Imperial College London , London, UK.
authors.forename: Eko G
authors.initials: EG
authors.lastname: Zhang
authors.forename: Fiona
authors.initials: F
authors.lastname: Regan
authors.forename: Mark
authors.initials: M
authors.lastname: Layton
authors.forename: Gowrishankar
authors.initials: G
authors.lastname: Paramasivam
authors.forename: Jo
authors.initials: J
authors.lastname: Wyatt-Ashmead
authors.forename: Irene
authors.initials: I
authors.lastname: Roberts
authors.forename: Sailesh
authors.initials: S
authors.lastname: Kumar
mesh_terms: D000740:Anemia / Q000151:congenital / Q000401:mortality / Q000628:therapy*; D001805:Blood Transfusion, Intrauterine; D002648:Child; D017809:Fatal Outcome; D005260:Female; D005315:Fetal Diseases / Q000401:mortality / Q000628:therapy*; D006801:Humans; D007231:Infant, Newborn; D011247:Pregnancy; D011250:Pregnancy Complications, Hematologic / Q000628:therapy; D012720:Severity of Illness Index