Faculdade de Ciencias Medicas de Santos, Centro Universitario Lusiada, Santos, Brazil.
Center for Fetal Therapy, Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Fetal Diagn Ther. 2019;45(5):361-364. doi: 10.1159/000492750. Epub 2018 Sep 10.
Fetomaternal hemorrhage (FMH) is a rare condition that requires early diagnosis and appropriate treatment due to its potentially severe consequences. We report a case of massive FMH presenting as decreased fetal movement, fetal hydrops, and intracranial hemorrhage at 24 weeks. Treatment considerations were made and amniocentesis, fetal blood sampling, and fetal blood transfusion via cordocentesis were performed. Recurrent FMH required subsequent fetal transfusion 2 days later. Surveillance was continued twice weekly until the patient delivered a viable infant at 38 weeks after spontaneous labor. Recurrent FMH was unpredictable due to its unclear etiology and absence of precipitating events, however close surveillance proved effective.
胎儿母体出血（FMH）是一种罕见的病症，由于其潜在的严重后果，需要早期诊断和适当的治疗。我们报告了一例 24 周时表现为胎动减少、胎儿水肿和颅内出血的大量 FMH 病例。进行了治疗考虑，并进行了羊膜穿刺术、胎儿血液取样和通过脐带穿刺术进行胎儿输血。2 天后，因反复出现 FMH 再次进行胎儿输血。每周监测两次，直到患者在自发分娩后 38 周分娩出一个有活力的婴儿。由于病因不明且无诱发事件，反复出现 FMH 是不可预测的，但密切监测证明是有效的。
