Fetomaternal transfusion : a cause of anemia at birth

Abstract

It has been estimated that the passage of fetal erythrocytes into the maternal circulation (feto-maternal transfusion) occurs normally in about 50 percent of all pregnancies. This is the mechanism underlying Rh-isoimmunisation of the newborn and except in these cases it is usually of no consequence because the majority of such hemorrhages are small. In some cases, however, the bleed is of sufficient degree to cause anemia, shock or even stillbirth. Two cases of feto-maternal transfusion are described, whereby the clinical picture, diagnosis and treatment are reported. The differential diagnosis of anemia at birth is not usually difficult and a list of causes is illustrated in a table. There are two main groups of conditions causing obvious anemia at birth. The first and by far the commonest is hemolytic anemia and the second group is anemia caused by intrauterine hemorrhage. Treatment depends on the degree of anemia and the general condition of the baby.