[Massive feto-maternal hemorrhage. Diagnosis, quantitation, etiology and (para-clinical findings)].

Massive feto-maternal haemorrhage occurs with a frequency of approximately 1 out of 1,000 deliveries and involves a considerable risk for intrauterine/perinatal morbidity and mortality. Three cases of massive feto-maternal haemorrhage are described. Methods of diagnosis and quantitation are reviewed. The etiological conditions are briefly mentioned and clinical and paraclinical aspects in the fetus/infant and also the mother are reviewed. Investigation for feto-maternal haemorrhage should be undertaken in all cases of unexplained stillbirth and perinatal death and in all cases with hypovolaemic shock or non-haemolytic anaemia in neonates. In addition, investigation should be undertaken in selected cases with deterioration of fetal condition after eg trauma to the uterus, external version and amniocentesis, particularly in cases with massive vaginal haemorrhage and/or aspiration of haemorrhagic amniotic fluid. In these latter cases, it may also be of value to carry out Kleihauer's test on aspirate from the vagina and/or amniotic fluid with the object of determining whether the haemorrhage is of fetal or maternal origin.