Fliegner J R, Fortune D W, Barrie J U
Department of Obstetrics & Gynaecology, Royal Women's Hospital, Melbourne.
Aust N Z J Obstet Gynaecol. 1987 May;27(2):158-61. doi: 10.1111/j.1479-828x.1987.tb00971.x.
Spontaneous fetomaternal haemorrhage is an important, but usually overlooked, cause of perinatal mortality and morbidity. Although fetomaternal bleeding in the third trimester of pregnancy is common it is normally less than 0.1 ml. A fetal macrotransfusion (greater than 5 ml) is uncommon, but is important because it is insidious, unexpected and usually occurs in completely normal pregnancies. This paper analyses the perinatal mortality and morbidity associated with occult fetomaternal haemorrhage at the Royal Women's Hospital, Melbourne. It may lead to fetal distress before and during labour, unexplained stillbirth, or nonhaemolytic neonatal anaemia. A Kleihauer test on maternal blood will readily detect fetomaternal bleeding, and we describe a simple way of calculating the absolute volume of fetal red cells present. Greater awareness of the problem may eventually lead to diagnosis sufficiently early to permit effective treatment.
自然发生的胎儿-母体出血是围产期死亡率和发病率的一个重要但通常被忽视的原因。虽然妊娠晚期的胎儿-母体出血很常见，但通常少于0.1毫升。胎儿大量输血（超过5毫升）并不常见，但很重要，因为它隐匿、意外，且通常发生在完全正常的妊娠中。本文分析了墨尔本皇家妇女医院与隐匿性胎儿-母体出血相关的围产期死亡率和发病率。它可能导致分娩前和分娩期间的胎儿窘迫、原因不明的死产或非溶血性新生儿贫血。对母体血液进行克莱豪尔试验可轻易检测出胎儿-母体出血，我们描述了一种计算存在的胎儿红细胞绝对体积的简单方法。对该问题有更高的认识最终可能会促使足够早地做出诊断，从而进行有效治疗。
