Chronic Massive Fetomaternal Hemorrhage:

Fetomaternal hemorrhage (FMH) of more than 30 ml is relatively rare. In a complicated pregnancy, FMH of more than 30 ml occurs with the frequency of about 1/300. Massive FMH can cause severe neonatal anemia and even fetal death. We report a case of a male newborn, who was delivered at our hospital without perinatal asphyxia or obstetric complications. The baby was hemodynamically stable after birth, manifesting only pallor. The complete blood count revealed severe hypochromic anemia (hemoglobin 6.2 g/dL, hematocrit 20.5 %) and reticulocytosis (reticulocyte 37.5%). There was no ABO blood type incompatibility and the result of direct Coomb’s test was negative. A Klei-hauer-Betke stain on a maternal blood sample was performed and the result was positive with 16 % red blood cells re-sistant to alkali, which is equivalent to 800 ml of fetal blood loss in the maternal circulation. After a packed red blood cell transfusion, the baby’s condition improved. (Clinical Neonatology 1998;5(1): 35-37) Key word: Fetomaternal hemorrhage, Neonatal anemia, Kleihauer-Betke stain The ability of fetal red cells passing the placental mem-brane was demonstrated by Chown in 1954 [1]. Fetal red cells in the maternal circulation can be detected with the Kleihauer acid-elution method by relative acid resistance from fetal hemoglobin to adult hemoglobin [2]. Abou