OJOG  Vol.1 No.3 , September 2011
Transplacental haemorrhage in women having third trimester bleeding and perinatal outcome
ABSTRACT
Objectives: Present prospective study was carried out to know the frequency of transplacental fetomaternal hemorrhage in pregnancies complicated by third trimester vaginal bleeding and it’s correlation with fetoneonatal outcome. Material methods: One hundred, out of 170 Rh-positive primigravida/multigravida with singleton pregnancy of more than 28 weeks gestation, admitted with third trimester vaginal bleeding with no other obstetric disorder, were the study subjects and 100 controls were women with no bleeding, admitted immediately after the study case with same inclusion and exclusion criteria. Maternal peripheral blood was collected at admission and at 2 hours of delivery and volume of FMH was calculated by Kleihauer’s formula. Results: Statistically significantly more perinatal deaths occurred in women with FMH, 35% in study subjects compared to 2.7% amongst controls. Conclusion: In the cases of third trimester bleeding and fetomaternal hemorrhage, chances of perinatal deaths are more.

Cite this paper
nullChhabra, S. , Kaur, P. , Tickoo, C. and Zode, P. (2011) Transplacental haemorrhage in women having third trimester bleeding and perinatal outcome. Open Journal of Obstetrics and Gynecology, 1, 149-152. doi: 10.4236/ojog.2011.13028.
References
[1]   Marions, L. and Thomassen, P. (1991) Six cases of mas- sive fetomaternal bleeding causing intra-uterine fetal death. Acta Obstetical et Gynecologica Scandinavica, 70, 85-88. doi:10.3109/00016349109006184

[2]   Arias, F. (2000) Third trimester bleeding. In: Practical guide to high risk pregnancy and delivery. 2nd Edition, Singapore, Harcourt Brace Asia, 162-182.

[3]   Claydon, C.S. and Pernoll, M.L. (2003) Third trimester vaginal bleeding. In: de cheeney ah, nathan l, eds. current obstetric and gynecologic diagnosis and treatment 9th ed. Lange Medical Books and Mc Graw Hill Company, New York, 354-368.

[4]   Choavartana, R., Ver-Arrewong, S. and Makanantakosal, S. (1997) Fetomaternal transfusion in normal pregnancy and during delivery. Journal of the Medical Association of Thailand, 80, 96-100.

[5]   Cunningham, F.G., Gant, N.F., Leveno, K.J., Gilstrap, L.C., Hauth, J.C. and Wenstrom, K.O. (2001) Obstetric hemorrhage. Williams obstetrics. 21st Editon, International edition, Mc Graw Hill, 619-635.

[6]   Almeida, V., Bowman, J.M., Victor, M.D. and John, M.D. (1994) Massive fetomaternal hemorrhage, manitoba experience. Obstetrics and Gynecology, 83, 323-328.

[7]   Giacoia, G.P. (1997) Severe FMH: A review. Obstetric Gynecology Survey, 52, 372-380. doi:10.1097/00006254-199706000-00022

[8]   O’Connolly, A.M., Katz, V.L., Bash, K.L., McMahon, M.J. and Hansen, W.F. (1997) Trauma & pregnancy. American Journal of Perinatology, 14, 331.

[9]   Jansen, M.W., Korver-Hakkennes, K., Van Leenen, D, Visser, W., Groot, C.J. and Wladimiroff, J.W. (2001) Significantly higher number of fetal cells in the maternal circulation of women with preeclampsia. Prenat Diagn, 21, 1022-1026. doi:10.1002/pd.176

[10]   Gordon, H. and Bhoyroo, S.K. (1966) A study of fetal erythrocytes in the maternal circulation during the antenatal period. Obstetrics and Gynecology, 73, 571-574. doi:10.1111/j.1471-0528.1966.tb15535.x

[11]   Sebring, S.H. and Polesky, H.F. (1990) Fetomaternal hemorrhage incidence, risk factor, time of occurrence, and clinical effects. Transfusion, 30, 344-357. doi:10.1046/j.1537-2995.1990.30490273444.x

[12]   Boyle, J., Kin, J., Walerius, H. and Sammuels, B. (1996) The clinical use of the Kleihauer Betke test in Rh positive patients. American Journal of Obstetrics and Gynecology, 174, 343.

[13]   Kleinhuer, E., Braun, H. and Betke, K. (1957) Demonstration von fetalen hemoglobin in den erythrocytes eins Blutanusstrichs. Klin Wochenschr, 35, 637. doi:10.1007/BF01481043

[14]   Apt, L. and Downey, W.S., (1955) Melena Neonatorum, the swallowed blood syndrome, a simple test for the differentiation of adult & fetal hemoglobin in bloody stools. The Journal of Pediatrics, 47, 6-12. doi:10.1016/S0022-3476(55)80118-7

[15]   Ogita, S., Ishiko, O., Matsumoto M, Hasegawa H. and Sugawa, T. (1976) A simplified method of measuring fetal hemoglobin. Obstetrics and Gynecology, 48, 237-238.

[16]   Kleinhauer, E. and Betke, K. (1960) Practical use of the demonstrated of cells containing hemoglobin F in fixed blood smears. Internist (Berlin), 1, 292-295.

[17]   Kleinhuer, E., (1966) Fetalen hemoglobin and fetale erythrocytes. Suppl Arch Kinderheilk, 53, 76.

[18]   Bartsch, F.K. (1972) Fetale eruthrozten immutterlichen blut and immunoprophylaxe der Rh immunisierung. Acta Obstet Gynecol Scand (Suppl), 20, 1-128.

[19]   Jorgensen, J. (1977) Fetomaternal bleeding, bleeding. Acta Obstet Gynaecol Scand, 56, 7-490.

[20]   Burch, D. (1997) Computerised measurement of fetal heart rate variation in a case of FMH. British Journal Obstetrics & Gynecology, 101, 1089.

[21]   Froen, J.F., Vege, A. and Ormerod, E. (2001) Stray— Pedersen B. Finding the cause of death in intrauterine death-which examination should be done? PMID 11242876. Tidsskr nor Laegeforen, 121, 326-330.

[22]   Jones, D.R. and Smith, T.R. (2004) Transplacental hemorrhage in pregnancies complicated by third trimester bleeding. Acta Obstet Gynecol Scand, 50, 65-67.

[23]   Frazer, I.D. and Raper, A.B. (1962) Observation of compatible and incompatible and fetal red cells in the maternal circulation. Provincial Medical and Surgical Journal British Medical Journal, 2, 303-304.

[24]   Zipursky, A. (1971) The universal prevention of Rh immunization. Clin Obstet Gynecol, 14, 869-884. doi:10.1097/00003081-197109000-00013

[25]   Kizza, A.P. and Rogo, K.O. (1990) FMH in Kenya. East African Medical Journal, 67, 801-807.

[26]   Stettler, R.W. and Lutich, A., Pritchard, T.A. and Cunningham, F.G. (1992) Traumatic placental abruption. Presented at the American College of Obstet Gynecol. Annual clinical meeting, Las Vagas, April 1992.

[27]   Minchin, A.J. and Bhoyroo, S.K. (1970) Feto-maternal transfusion in APH, an index of placental damage & fetal risk. Obstetrics and Gynecology, 77, 781-784. doi:10.1111/j.1471-0528.1970.tb04398.x

[28]   Halcomb, W.L. Gunderson, E. and Petrie, R.H. (1990) Clinical use of the kleihauer betke test. Journal of Perinatal Medicine, 18, 331-337. doi:10.1515/jpme.1990.18.5.331

[29]   Samadi, R., Greenspoon, J.S., Gviazda, I., Settlage, R.H. and Goodwin, T.M. (1999) Massive fetomaternal hemorrhage and fetal death are they predictable. Journal of Perinatology, 19, 227-229. doi:10.1038/sj.jp.7200144

[30]   Zizka, Z., Calda, P., Zlatohlavkova, B., Haakova, L., Cerna, M., Jirasek, J.E., Fait, T. and Hajtk, Z. (2001) Kvasnicka JMassive peritology problem, role of ABO fetomaternaal compatibility-case studies. Mdical Science Monitor, 7, 308-311.

 
 
Top