[Anaemia in two infants due to fetomaternal transfusion]

In two neonates, a boy suffering from persistent pulmonary hypertension of the newborn and a girl with fetal distress, massive fetomaternal haemorrhage was diagnosed (290 ml). In both cases fetal monitoring showed a sinusoidal heart rate pattern and the Kleihauer-Betke test was positive. Both children were intubated and ventilated and were given an erythrocyte transfusion. They both recovered. Differentiation between acute and chronic fetomaternal haemorrhage is essential when deciding on treatment: blood transfusion in acute fetomaternal haemorrhage and exchange transfusion in chronic fetomaternal haemorrhage with normoor hypervolemia. Differentiation is difficult. Little is known about the prognosis of fetomaternal haemorrhage. Because of the nature of perinatal problems and the possibility of neurological damage, long-term follow-up is recommended.