Computerised measurement of fetal heart rate variation in a case of fetomaternal haemorrhage

Burch, David

doi:10.1111/j.1471-0528.1994.tb13591.x

Cited by 14 publications

(3 citation statements)

References 9 publications

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“…11 Tsuda et al evaluated prognostic factors for outcomes of fetomaternal haemorrhage. In their series, maternal fetal haemoglobin levels less than 5%, ie maternal blood containing 5% fetal blood cells, were associated with good prognosis (< 250 mL fetal blood 10 These criteria were correctly predictive in this case report. The intrauterine death occurred with a 350 mL blood loss.…”

Section: Casementioning

confidence: 49%

“…6 Burch recommends Kleihauer testing when a woman complains of decreased fetal movements and decreased variability is noted on cardiotocography. 10 A review of presenting features of fetomaternal haemorrhage by Giacoia in 1997 1 found decreased or absent fetal body movements to be present in 35% of cases, still births to comprise 12.5%, sinusoidal heart rate pattern to be found in 1% of cases.…”

Section: Casementioning

confidence: 97%

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Fetomaternal haemorrhage – can we improve the outcome?

Kew

Lim

2002

Aust NZ J Obst Gynaeco

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A 30-year-old primigravida presented to the delivery suite at 36 weeks gestation with a three-hour history of decreased fetal movements. Her antenatal history was unremarkable. CTG showed a sinusoidal pattern with a baseline of 135 bpm but absent decelerations. An ultrasound scan showed the growth and amniotic fluid parameters to be within normal limits. Umbilical artery Doppler studies were normal but fetal movements were observed to be absent during the examination. As there was a suspicion of fetomaternal haemorrhage, a Kleihauer test was requested and was noted to be strongly positive. The CTG trace continued to be abnormal with development of decelerations ( Figure 1).A decision for emergency caesarean section was made. A live, pale infant weighing 3500 g was delivered with Apgar scores of 7 at 1 minute and 8 at 5 minutes. The child was immediately intubated and ventilated. The haemoglobin of the infant at birth was 3.4 g/dL, necessitating transfusion, and the pH of the umbilical arterial blood was 6.9. No reticulocyte count was carried out, although the mean corpuscular volume was raised at 110.8 fL. The histological examination of the placenta was normal. Subsequent problems encountered included pneumothorax requiring a chest drain, and pulmonary hypertension.The child was subsequently transferred to a tertiary centre for oscillation ventilation and nitric oxide. The subsequent course remained stormy, the infant enduring a cardiac arrest, pulmonary haemorrhage, sepsis and requiring repeat transfusions. The infant had grade I intraventricular haemorrhage, requiring phenobarbitone, but is now doing well.The mother was Rhesus (D) positive, and so did not require anti-D gamma globulin.

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Section: Casementioning

confidence: 49%

Section: Casementioning

confidence: 97%

Fetomaternal haemorrhage – can we improve the outcome?

Kew

Lim

2002

Aust NZ J Obst Gynaeco

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“…FMH has been reported to occur in 25% -50% of all pregnancies [18,19] however higher incidence (60% -70%) has been reported in pregnancies complicated by bleeding in third trimester [1,4,12,[20][21][22]. Theoretically placental separation may lead to increased chances of fetal blood going into maternal circulation.…”

Section: Discussionmentioning

confidence: 99%

Transplacental haemorrhage in women having third trimester bleeding and perinatal outcome

Chhabra¹,

Kaur²,

Tickoo³

et al. 2011

OJOG

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Objectives: Present prospective study was carried out to know the frequency of transplacental fetomaternal hemorrhage in pregnancies complicated by third trimester vaginal bleeding and it's correlation with fetoneonatal outcome. Material methods: One hundred, out of 170 Rh-positive primigravida/multigravida with singleton pregnancy of more than 28 weeks gestation, admitted with third trimester vaginal bleeding with no other obstetric disorder, were the study subjects and 100 controls were women with no bleeding, admitted immediately after the study case with same inclusion and exclusion criteria. Maternal peripheral blood was collected at admission and at 2 hours of delivery and volume of FMH was calculated by Kleihauer's formula. Results: Statistically significantly more perinatal deaths occurred in women with FMH, 35% in study subjects compared to 2.7% amongst controls. Conclusion: In the cases of third trimester bleeding and fetomaternal hemorrhage, chances of perinatal deaths are more.

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