胎母输血综合征

胎母输血综合征(fetomaternal hemorrhage,FMH)是指一定量胎儿血液通过破损的胎盘绒毛间隙进入母体血液循环,引起胎儿不同程度的失血以及母亲溶血性输血反应的临床征候群。该病是一种少见的产科疾病,是胎儿非免疫     

胎母输血综合征

胎母输血综合征（FMH）是一种少见的产科并发症，大部分病例原因不明。FMH临床表现为胎动减少、正弦曲线样胎心监护、胎儿水肿等。严重病例胎死宫内。在母体血循环检测到胎儿红细胞可以诊断FMH。早期发现，通过连续宫内输血可使该综合征得到有效治疗。仍需探索更好的检测方法帮助早期诊断。     

胎母输血综合征

胎母输血综合征(FMH)是一种少见的产科并发症,大部分病例原因不明.FMH临床表现为胎动减少、正弦曲线样胎心监护、胎儿水肿等.严重病例胎死宫内.在母体血循环检测到胎儿红细胞可以诊断FMH.早期发现,通过连续宫内输血可使该综合征得到有效治疗.仍需探索更好的检测方法帮助早期诊断.     

胎母输血综合征4例

胎母输血综合征(fetomaternal hemorrhage,FMH)是一种少见的产科疾病,是指一定量的胎儿血液通过破损的胎盘绒毛进入母体血循环,引起胎儿失血以及母亲和胎儿溶血性反应的临床症候群.因为它临床表现的隐匿性,并且母亲发生溶血性贫血症状少见,几乎无特异性临床表现,因此在多数情况下不易做出早期诊断,故围生儿死亡率较高.我院在2008～2009年连续发生4例FMH患者,现将临床资料进行分析,探讨FMH的病因、临床特征、诊断及治疗,以期提高对本病的认识.     

胎母输血综合征1例

患者30岁,G1P0,因宫内孕38+6周,羊水过少于2008年9月26日急诊收入院.患者孕期经过顺利.孕35～38周体重、宫高、腹围均无增长.血型AB型,Rh阳性.     

胎母输血综合征1例

1病例报告患者,25岁,G1P0。因孕37周,阵发性下腹痛7小时于2010年8月29日入院。孕期进行正规产前检查,未发现明显异常。7小时前无明显诱因出现阵发性下腹痛伴腰酸,无阴道流血、流液,无恶心、呕吐等。入院2天后(8月31日)胎心监护,NST提示无加速,持续20分钟。B超检查提示胎儿双顶径     

胎母输血综合征继发绒癌一例

<正>一、病例摘要患者19岁,孕1产0,因"停经39周,自觉胎动减少1 d"入中国科学院大学深圳医院。患者月经规则,孕14周建册定期产检,无特殊情况,夫妻地中海贫血筛查正常、G1P0、无创DNA、糖耐量检查无异常。孕30周彩超提示臀位,脐带绕颈1周,予远程胎监监护。孕38周因"新冠疫情"未产检,自测胎心正常。患者2020年2月6日自觉胎动减少,述远程胎监与以往略不同,但未上传结果或就诊,2月7日胎动明显减少,伴不规则下腹坠胀就诊,无阴道流血、流液。胎心监测多次出现晚期减速,胎心基线150次/分,变异3～5 bpm,无明显加速,     

胎母输血综合征2例报道

<正>胎母输血综合征(fetomaternal hemorrhage,FMH)是指一定量的胎儿血液通过破损的胎盘绒毛进入母体血液循环,引起胎儿失血及母亲和胎儿溶血反应的临床症状,较为少见。本病发病隐匿,缺乏特异性症状和统一的诊断标准,早期诊断困难。FMH容易引起胎儿贫血和发育受限,严重时可导致胎儿死亡,围生儿病死率达33%~50%~([1])。我院近年诊治FMH病例2例,现报道如下。     

胎母输血综合征7例分析

目的探讨胎母输血综合征(FMH)的临床特点。方法对首都医科大学附属北京妇产医院2006年1月1日至2008年12月31日分娩的7例FMH临床资料进行回顾性分析。结果 7例FMH患者的主要临床表现是胎动减少,胎心监护显示基线平直,短变异消失,当胎儿已经贫血时,并非全部表现出正弦样曲线。7例新生儿均贫血,估计胎儿失血量57～203mL。所有新生儿均存活。结论当无明显原因出现胎心基线短变异消失,伴胎动减少时,或有高危因素存在时,应考虑到FMH可能。应通过简便易行的红细胞酸洗脱试验进行产前诊断,估算胎儿失血量。     

Massive fetomaternal hemorrhage and oxytocin contraction test: case report and review

We present a case of a nulliparous woman who underwent oxytocin contraction test because of abnormal cardiotocograph. She delivered a severely anemic neonate due to severe fetomaternal hemorrhage. Fetal ultrasonography and Doppler studies of the umbilical arteries may not be helpful, while its worthy to perform flow cytometry for detection of fetal cells in maternal circulation when there is strong clinical suspicion. Management of massive fetomaternal hemorrhage requires immediate delivery by Caesarian section if the gestational age is suitable. Alternatively, for very premature fetuses could be used serial fetal intravascular transfusions if there are the necessary facilities and experienced personnel.     

Successful treatment of hydrops fetalis caused by fetomaternal hemorrhage: a case report

Nonimmune hydrops fetalis is a serious perinatal complication with diverse causes but few successful treatment modalities. The first reported case of hydrops fetalis caused by a massive fetomaternal hemorrhage treated successfully prenatally is presented. A modification of the standard intrauterine transfusion technique was used for therapy. Implications of future treatment are discussed.     

Severe fetomaternal hemorrhage. A report of four cases

Four cases of severe fetomaternal hemorrhage (FMH) presented with severe anemia and signs of circulatory failure. One of the patients developed the syndrome of persistent fetal circulation. The diagnosis of FMH was confirmed in all using Kleihauer-Betke tests, which demonstrated abundant fetal erythrocytes in the maternal circulation. Three infants survived after prompt volume replacement and correction of anemia. The only fatality was related to an underlying chromosomal disorder. The majority of reported neonatal deaths due to FMH have occurred when shock was the presenting manifestation.     

Shock management in acute fetomaternal hemorrhage

Abstract

The determination of fetal head position can be useful in labor to predict the success of labor management, especially in case of malpositions. Malpositions are abnormal positions of the vertex of the fetal head and account for the large part of indication for cesarean sections for dystocic labor. The occiput posterior position occurs in 15–25% of patients before labor at term and, however, most occiput posterior presentations rotate during labor, so that the incidence of occiput posterior at vaginal birth is approximately 5–7%. Persistence of the occiput posterior position is associated with higher rate of interventions and with maternal and neonatal complications and the knowledge of the exact position of the fetal head is of paramount importance prior to any operative vaginal delivery, for both the safe positioning of the instrument that may be used (i.e. forceps versus vacuum) and for its successful outcome. Ultrasound (US) diagnosed occiput posterior position during labor can predict occiput posterior position at birth. By these evidences, the time requested for fetal head descent and the position in the birth canal, had an impact on the diagnosis of labor progression or arrested labor. To try to reduce this pitfalls, authors developed a new algorithm, applied to intrapartum US and based on suitable US pictures, that sets out, in detail, the quantitative evaluation, in degrees, of the occiput posterior position of the fetal head in the pelvis and the birth canal, respectively, in the first and second stage of labor. Authors tested this computer system in a settle of patients in labor.