Antepartum fetomaternal hemorrhage. Report of a case with the use of cordocentesis in diagnosis and management

Abstract

Clinical recognition of antepartum fetomaternal hemorrhage (FMH) is most often achieved by the observation of characteristic fetal heart rate (FHR) patterns and positive Kleihauer-Betke acid elution staining. Both methods are noted to lack sensitivity and specificity. A case of suspected antepartum FMH occurred with intermittent sinusoidal FHR tracings. Fetal blood sampling by cordocentesis in situations with equivocal antenatal testing, such as in this case, allows not only confirmation of fetal anemia but assessment of fetal acid-base status. In pregnancies of less than 32 weeks' gestation complicated by severe antepartum FMH, intravascular transfusion may be offered via this technique. Cordocentesis is beneficial in the management of pregnancies with uncertain FHR patterns when antepartum FMH is suspected.