[Fetomaternal macrotransfusion--a cause for decreased fetal movements. 2 cases]

Two cases of fetomaternal macrotransfusion in otherwise normal pregnancies are reported. In both cases the main symptoms observed by the patients were decreasing fetal movements. Cardiotocography revealed a highly pathologic pattern an immediate cesarean section was performed. The cause of massive fetomaternal hemorrhage (390 and 635 ml fetal blood) remains unclear. Delayed treatment leads to severe anemia followed by hypovolemic shock and ultimately to stillbirth. Pregnancies complicated by fetomaternal hemorrhage develop normally until signs of fetal decompensation begin to appear. Decreasing fetal movements in the most common symptom reported by the patients. In addition to a contraction-stress-test, blood from the pregnant women should be looked at for fetal erythrocytes, a test that can be performed very quickly and easily. If the fetus is viable, immediate delivery should be performed and blood transfusions to the newborn should be administered. In preterm pregnancies cordocentesis and intrauterine blood transfusion may be considered.