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Licensed Unlicensed Requires Authentication Published by De Gruyter July 27, 2018

Untimely diagnosis of fetomaternal hemorrhage: what went wrong?

  • Isabella Piva EMAIL logo , Piergiorgio Iannone ORCID logo , Danila Morano and Pantaleo Greco

Abstract

Fetomaternal hemorrhage (FMH) is an obstetrical challenge. It is defined as a passage of fetal blood into the maternal circulation or vice versa, which might complicate pregnancy or delivery. Most cases of acute and chronic FMH are idiopathic in origin and involve uncomplicated near-term pregnancies. Yet, due to the lack of universal screening, heterogeneous clinical presentation and insufficient clinicians awareness, in some cases FMH may present as immediate fetal compromise or even stillbirth as the most devastating consequence. We made a review of the literature of the FMH clinical cases of fetal/neonatal death in order to focus on the available diagnostic tools and their limitations. Cardiotocography, biophysical profile, middle cerebral artery peak systolic volume and current laboratory tests were studied and evaluated as diagnostic tools for FMH. International guidelines are needed to help clinicians make a prompt identification of FMH. Moreover, a standardized management protocol is essential in order to improve fetal-neonatal outcomes.


Corresponding author: Dr. Isabella Piva, MD, Department of Morphology, Surgery and Experimental Medicine, Institute of Obstetrics and Gynecology, Azienda Ospedaliero-Universitaria S. Anna, University Hospital of Ferrara, Via Aldo Moro 8, 44124 Cona, Ferrara, Italy, Tel.: +393497905494

  1. Author contributions: All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.

  2. Research funding: None declared.

  3. Employment or leadership: None declared.

  4. Honorarium: None declared.

  5. Competing interests: The funding organization(s) played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.

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Received: 2017-11-05
Accepted: 2018-05-07
Published Online: 2018-07-27
Published in Print: 2018-12-19

©2019 Walter de Gruyter GmbH, Berlin/Boston

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