Fetomaternal hemorrhage: a case highlighting the significance of multifaceted prenatal detection and timely
Yuchi Gao1,2, Guikai Duan1, Qinglin Ma1
1Department of Clinical Laboratory, Shenzhen Maternity and Child Healthcare Hospital, Southern Medical University, Shenzhen, Guangdong Province, China.
Introduction:
Fetomaternal hemorrhage (FMH), a life-threatening obstetric complication with high concealment and poor prognosis, is mostly postnatally diagnosed.
Case Report:
This case reports the 30 years old primigravida at 32 + 1 weeks, preoperatively identified with FMH via combined indicators: markedly elevated maternal serum alpha-fetoprotein (AFP) (16698.2 μg/L post-dilution), decreased fetal movement, two non-reassuring fetal heart rate tracings, and polyhydramnios. Emergency cesarean section was done. The neonate had severe anemia (Hb 5.9 g/dL) and metabolic acidosis, with Hb rising to 137 g/dL after 26 mL packed red blood cell transfusion. Maternal K-B test confirmed 1.1% fetal Hb (116 mL blood loss). The neonate was discharged at 40 + 2 weeks corrected gestational age.
Conclusion:
This case emphasizes that the integration of multiple prenatal clinical and laboratory cues facilitates early detection of FMH, thereby contributing to improved perinatal prognosis.
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