Fetomaternal hemorrhage in normal vaginal delivery and in delivery by cesarean section

Abstract

During normal vaginal delivery as well as during delivery by cesarean section, FMH of less than 5 mL occurs in the great majority of cases, and thus for the prevention of D alloimmunization, an IgG anti-D dose of 100 µg should be sufficient. Contrarily, only rarely does greater FMH occur and delivery by cesarean section does not present a risk factor.

Consequences of being Rhesus D immunized during pregnancy and how to optimize new prevention strategies

“…With the fetal RHD genotype known early in pregnancy, anti‐D prophylaxis could be administered routinely in gestational week 38 to provide protection at term and later. A high enough dose at this gestational age will normally protect against sensitization after delivery and a postnatal dose will not be necessary, at least not after an uncomplicated delivery, within 3 weeks of the injection . Whether a repeat dose at 38 weeks of gestation can safely replace the postnatal administration requires further investigations.…”

Noninvasive Single-Exon Fetal RHD Determination in a Routine Screening Program in Early Pregnancy

“…A large study summarizing data on FMH after delivery in 20.000 7 pregnancies found that in 96 percent of women the FMH was less than 1 ml fetal blood and in 98 percent less than 2 ml 28 . A recent prospective study evaluating FMH using flow cytometry after delivery in normal vaginal delivery and cesarean section in 3457 women found that in 99.7 percent of women the FMH at delivery was ≤ 10 ml fetal blood 53 .…”

Fatores associados à cesariana entre primíparas adolescentes no Brasil, 2011-2012

“…Several authors have pointed out the maternal and child morbidity and mortality risks associated with caesarean sections 3,4,5,6,7 and these risks are substantially greater for elective caesarean sections compared to normal birth 8 . The possibility of complications in subsequent pregnancies is also greater following a caesarean, including anomalies of the placenta, stillbirths and neonatal morbidity and mortality 9,10 , and such problems show a standard dose-response according to the number of previous caesarean sections 10,11 .…”