[Severe neonatal anemia associated with fetomaternal transfusion and persistent fetal circulation]

A newborn infant with massive fetomaternal hemorrhage is reported. The fetal blood loss led to severe late decelerations in the antepartal CTG. The newborn showed a marked anemia (Hb 4.9 g%!) and a rapidly progressive heart failure. Despite blood transfusions and digoxin therapy the infant developed the symptoms of a "persistent fetal circulation". This mechanism may have been responsible for the lethal outcome in other reported cases. A successful therapeutic approach adaptable to the different stages of severity of this dangerous perinatal condition is outlined.