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Massive fetomaternal hemorrhage and oxytocin contraction test: case report and review
Panagiotis Bakas1, Angelos Liapis, Maria Giner
12nd Department of Obstetrics and Gynecology, University of Athens, Aretaieio Hospital, Alexandras Avenue 108, Greece 11522. eurotas@ath.forthnet.gr
We present a case of a nulliparous woman who underwent oxytocin contraction test because of abnormal cardiotocograph. She delivered a severely anemic neonate due to severe fetomaternal hemorrhage. Fetal ultrasonography and Doppler studies of the umbilical arteries may not be helpful, while its worthy to perform flow cytometry for detection of fetal cells in maternal circulation when there is strong clinical suspicion. Management of massive fetomaternal hemorrhage requires immediate delivery by Caesarean section if the gestational age is suitable. Alternatively, for very premature fetuses could be used serial fetal intravascular transfusions if there are the necessary facilities and experienced personnel.
We present a case of a nulliparous woman who underwent oxytocin contraction test because of abnormal cardiotocograph. She delivered a severely anemic neonate due to severe fetomaternal hemorrhage. Fetal ultrasonography and Doppler studies of the umbilical arteries may not be helpful, while its worthy to perform flow cytometry for detection of fetal cells in maternal circulation when there is strong clinical suspicion. Management of massive fetomaternal hemorrhage requires immediate delivery by Caesarean section if the gestational age is suitable. Alternatively, for very premature fetuses could be used serial fetal intravascular transfusions if there are the necessary facilities and experienced personnel.