Nonimmune hydrops fetalis caused by a massive fetomaternal hemorrhage associated with elevated maternal serum alpha-fetoprotein levels. A case report.

Chronic fetomaternal hemorrhage led to the development of fetal anemia and nonimmune hydrops fetalis in a term neonate. Antenatal maternal serum alpha-fetoprotein levels were abnormally elevated, with normal amniotic fluid levels. Kleihauer-Betke staining was performed as part of the evaluation. Serial ultrasound examinations can be useful for unexplained elevations in maternal serum alpha-fetoprotein because of the associated increased fetal loss in those pregnancies. If fetomaternal hemorrhage is identified, serial ultrasound examinations are indicated for the detection of fetal hydrops.