CASE REPORT   

Minerva Obstetrics and Gynecology 2022 August;74(4):386-92

DOI: 10.23736/S2724-606X.21.04972-1

Copyright © 2021 EDIZIONI MINERVA MEDICA

language: English

Reduced fetal movements: the case of fetomaternal hemorrhage. Case series and proposal of a management protocol

Fernando FICAROLA ¹, Alessandro SVELATO ² ✉, Roberto ANGIOLI ¹, Rita ROSSI ³, Sara D’AVINO ², Caterina DE LUCA ², Denise RINALDO ⁴, Antonio RAGUSA ²

¹ Department of Obstetrics and Gynecology, Policlinico Campus Bio-Medico, Rome, Italy; ² Department of Obstetrics and Gynecology, San Giovanni Calibita, Fatebenefratelli Hospital, Isola Tiberina, Rome, Italy; ³ Department of Obstetrics and Gynecology, Massa Carrara General Hospital, Massa Carrara, Italy; ⁴ Department of Obstetrics and Gynecology, Bolognini General Hospital, Seriate, Bergamo, Italy

Fetomaternal hemorrhage (FMH) was reported more than 60 years ago for the first time defined by the transfer or transfusion of fetal blood into the maternal circulation before or during delivery. The transfused volume is usually very small but when this value exceeds, it may be clinically significant. Antenatal diagnosis of severe FMH is difficult and it can be suspected in case of reduction of fetal movements, abnormal cardiotocography and ultrasound. FMH is associated to different adverse outcomes and admission to neonatal intensive care. The low incidence of FMH limits the studies, thus being able to rely only on diagnosis and retrospective studies. We present case series of FMH and analyze the steps with the purpose of defining a flow-chart for early diagnosis and management of FMH.

KEY WORDS: Fetal movement; Hemorrhage; Fetus; Anemia