Shahar E, Birenbaum E, Inbar D, Brish M
Isr J Med Sci. 1981 Jun;17(6):441-4.
Three cases are described in which fetomaternal hemorrhage caused hypovolemic shock at birth. The etiology was confirmed by a postpartum maternal smear which showed approximately 15% of fetal red cells in the maternal circulation. All infants had severe anemia with hematocrit values of from 11 to 15%. Initial resuscitative measures included cardiac massage and artificial ventilation. Plasma expanders were given in order to restore the effective circulatory volume. Repeated blood transfusions resulted in an increase of blood pressure to normal range in all patients. One infant survived without neurological sequelae. The other two infants died following irreversible hypoxic injuries to vital organs. Early recognition of perinatal posthemorrhagic shock is crucial for recovery, and whole blood and plasma expander transfusions should be used immediately. Early assisted ventilation, administration of type O- whole blood and the autotransfusion of fetal blood are suggested for restoring the effective circulatory volume.
本文描述了三例胎儿-母体出血导致出生时低血容量性休克的病例。产后母体涂片证实了病因，该涂片显示母体循环中约15%为胎儿红细胞。所有婴儿均患有严重贫血，血细胞比容值为11%至15%。初始复苏措施包括心脏按压和人工通气。给予血浆扩容剂以恢复有效循环血量。反复输血使所有患者的血压升至正常范围。一名婴儿存活且无神经后遗症。另外两名婴儿因重要器官发生不可逆的缺氧损伤而死亡。围产期出血后休克的早期识别对恢复至关重要，应立即使用全血和血浆扩容剂进行输血。建议早期进行辅助通气、输注O型全血以及自体输血胎儿血以恢复有效循环血量。
