par Franckx, Johan;Sacre, Lydia
Référence Journal of perinatal medicine, 12, 3, page (147-150)
Publication Publié, 1984
Article révisé par les pairs
Résumé : A 29-year-old primipara with breech presentation had a spontaneous cephalic version of few days before her admission. She was hospitalised because of a sudden decrease in fetal movements. During labour a sinusoidal fetal heart rate pattern was observed. The mother gave birth to a strikingly pale 3250 g boy. His APGAR score was 1/5/6. Cord hemoglobin was 2.9 g/dl and an acid elution test showed the presence of 9.1% fetal red cells in the maternal circulation. Following a transfusion of packed cells and total blood, the baby's hemoglobin rose to above 10 g/dl. On the second day of life he developed an acute functional renal failure which responded well to fluid restriction and furosemide administration. Upon discharge, 10 days after birth, the physical and neurological examination were normal. At present, the child is two years old and thriving. Anemia in the newborn due to occult blood loss may be the result of bleeding of the fetus into the maternal circulation. The incidence of a massive transplacental blood loss is increased by traumatic amniocentesis, by external cephalic version and during cesarian section. As illustrated by the present case, spontaneous cephalic version may also account for feto-maternal transfusion in severe neonatal anemia. Severe anemia at birth secondary to an acute and massive feto-maternal hemorrhage is commonly associated with a poor prognosis. Under such conditions immediate re-expansion of the blood volume proved to be life saving.