Fetomaternal hemorrhage is very common and the commonest cause of anernia in the newborn. But, few blood cells enter the maternal circulation in most pregnancies. Occasionally large intrauterine bleeding results in severe fetal and neonatal anemia, shock, and rarely death. To identify the fetal blood in the maternal circu1ation, acid elution technique of Kleihauer-Betke test is usually used. And imrnedate neonatal blood transfusion should be done for good prognosis. We report a case of massive feto-maternal hemorrhage (>100 ml) in a preterm neonate with severe anemia at birth, which was diagnosed by Kleihauer-Betke test and was treated with blood transfusion.
Anemia ; Anemia, Neonatal ; Blood Cells ; Blood Transfusion ; Female ; Fetal Blood ; Fetomaternal Transfusion ; Hemorrhage* ; Humans ; Infant, Newborn ; Parturition ; Pregnancy ; Prognosis ; Shock

There are various causes of neonatal anemia, such as acute or chronic hemorrhage, ordinary hemolysis in combining with increasing of free bilirubin, decrease of erythropoiesis. Neonatal loss of blood can be seen prenatally, at birth or prosnatally. The diagnosis of neonatal anemia can be based on clinic observations or on some important examination such as Cooms test, reticulocyte, red blood cell mean volume. The management comprises of overcoming the causes heating anemia
Anemia ; blood ; Anemia, Neonatal

Massive fetomaternal hemorrhage is major cause of neonatal anemia. And neonatal anemia is fatal disease of high mortality rate. Massive fetomaternal hemorrhage is defined as hemorrhage of fetal blood above 150 mL in the maternal circulation. Massive fetomaternal hemorrhage is infrequent but represents a fatal cause of perinatal death. To identify fetal blood in the maternal circulation, Kleihauer-Betke test or flow cytometry has been usually used. But recently HPLC (high performance liquid chromatography) is used in the detection and quantification of fetomaternal transfusion. In fetomaternal transfusion, anemic newborn must be treated when circulatory failure is present. Circulatory failure often necessitates blood transfusion. We report two cases of severe anemia due to massive fetomaternal hemorrhage in full term baby. Each case was diagnosed by high performance lipuid chromatography and treated with exchange transfusion in order to avoid fluid overload and subsequent heart failure.
Anemia ; Anemia, Neonatal ; Blood Transfusion ; Chromatography ; Chromatography, High Pressure Liquid ; Female ; Fetal Blood ; Fetomaternal Transfusion ; Flow Cytometry ; Heart Failure ; Hemorrhage ; Humans ; Infant, Newborn ; Pregnancy ; Shock

Massive fetomaternal hemorrhage (FMH) is a major cause of unexplained fetal death and neonatal anemia. FMH can be diagnosed using the Kleihauer-Betke test or flow cytometry by identifying the presence of fetal red cells in the maternal blood. However, timely diagnosis is a challenge because many hospitals lack the equipment needed to perform such tests. The authors experienced a case of FMH diagnosed via high-performance liquid chromatography (HPLC) which is generally used in measuring glycated hemoglobin (HbA1c) in a patient with unexplained neonatal anemia. A girl aged 2 days was transferred to our hospital for showing pallor and a hemoglobin level of 5.0 g/dL. HPLC revealed 3% fetal hemoglobin (HbF) in the maternal blood. HPLC is a quick test for quantifying HbF that is readily available in many hospitals and could serve as a promising alternative for diagnosing FMH.
Anemia, Neonatal ; Chromatography, High Pressure Liquid ; Chromatography, Liquid ; Diagnosis ; Female ; Fetal Death ; Fetal Hemoglobin ; Fetomaternal Transfusion ; Flow Cytometry ; Hemoglobin A, Glycosylated ; Humans ; Infant, Newborn ; Pallor ; Pregnancy ; Prothrombin Time

OBJECTIVE: To investigate the safety of umbilical cord milking on both the mother and neonate among very preterm deliveries of less than 33 weeks of gestation. METHODS: Pregnant women who were expected to deliver at between 24 0/7 and 32 6/7 weeks of gestation were randomized to either the umbilical cord milking or immediate cord clamping group. Maternal and neonatal data associated with delivery, in addition to neonatal morbidity and mortality data, were collected and analyzed. RESULTS: Of the 66 preterm deliveries included in the study, 34 were randomized into the milking and 32 into the clamping group. Differences between maternal pre- and post-partum hemoglobin levels were 1.35 g/dL in the milking and 1.58 g/dL in the clamping group (P=0.451). Neonatal Apgar scores at both 1 and 5 minutes, initial blood gas analysis results, body temperature at admission, need for early intubation, and maximum bilirubin levels were all similar between the 2 groups. However, neonatal hemoglobin levels at birth (15.79 vs. 14.69 g/dL; P<0.05) and at 24 hours of age (14.83 vs. 13.29 g/dL; P<0.05) were significantly higher in the milking group. Neonates in the clamping group required more blood transfusion (1.78 vs. 0.93; P=0.049), and a higher percentage of neonates in the clamping group required inotropic drugs (63% vs. 29%; P=0.007). The mortality rate was significantly lower in the milking group (6% vs. 28%; P=0.015). CONCLUSION: Umbilical cord milking can be a safe and beneficial procedure for both the mother and the neonate in deliveries of less than 33 weeks of gestation.
Anemia, Neonatal ; Bilirubin ; Blood Gas Analysis ; Blood Transfusion ; Body Temperature ; Constriction ; Female ; Fetomaternal Transfusion ; Humans ; Infant, Newborn* ; Infant, Premature ; Intubation ; Milk* ; Mortality ; Mothers ; Parturition ; Pregnancy ; Pregnant Women ; Umbilical Cord*

Hemolysis anemia in neonate is always combined with the increase of blood free bilirubine. Therefore, almost cases of neonatal hemolysis anemia were diagnosed succesfully when neonatal jaundice was detected early, just a week after birth. The condition can be divided into two group: hemolysis due to congenital pathology of red blood cell and hemolysis acquired from outwards. Congenital hemolysis can lead to early anemia in neonate. The diagnosis of neonatal anemia can be based on some examinations such as Coombs test, reticulocyte or red cell mean volume, morpholosy of red cell, which can lead to find the cause of anemia
Anemia ; Hemolysis ; Blood Cells ; Anemia, Neonatal

No abstract available.
Anemia, Neonatal* ; Fetal Blood* ; Infant, Newborn

Klippel-Trenaunay syndrome (KTS) is a rare congenital disorder and is essentially a disorder of capillary, venous, and lymphatic malformations. Hematochezia is the most common symptom associated with intestinal hemangiomatosis and remains one of the life-threatening emergencies in KTS. We reported one patient of KTS presented with rectal bleeding and severe anemia who was successfully managed by sphincter-saving operation.
Anemia ; Capillaries ; Congenital, Hereditary, and Neonatal Diseases and Abnormalities ; Emergencies ; Gastrointestinal Hemorrhage ; Hemorrhage ; Humans ; Klippel-Trenaunay-Weber Syndrome

BACKGROUND: The direct/total (d/t) bilirubin ratio can be used to distinguish the causes of jaundice in many patients who have increased levels of direct and indirect bilirubin. However, the reference range of the d/t ratio has not been established, hindering its clinical usefulness. This study assessed the clinical usefulness of the d/t ratio. METHODS: Paired total bilirubin and direct bilirubin tests (N=4,357) of cholestasis, hemolytic anemia, and neonatal jaundice were evaluated. Regression analyses were performed between total bilirubin and direct bilirubin, and between total bilirubin and the d/t ratio for each disease. Theoretical correlation models were established and used to compare the regression analyses data. RESULTS: The theoretical model and regression equation between total bilirubin and direct bilirubin displayed linear correlations for all three cholestatic diseases. The model and regression equation between total bilirubin and the d/t ratio showed reciprocal curve correlations for the cholestatic diseases. When the total bilirubin concentration exceeded approximately 10 mg/dL, the rate of change of the d/t ratio decreased and converged to a constant value between 0.7 and 0.9. CONCLUSIONS: If the total bilirubin concentration exceeds 10 mg/dL, cholestatic diseases can be diagnosed if the d/t ratio is more than 0.7. However, if the total bilirubin concentration is lower than 10 mg/dL, cholestatic diseases should be considered even if the d/t ratio is lower than 0.7. Therefore, use of the d/t ratio with total bilirubin could prove to be valuable in clinical settings.
Anemia, Hemolytic ; Bilirubin* ; Cholestasis ; Humans ; Hyperbilirubinemia ; Infant, Newborn ; Jaundice ; Jaundice, Neonatal ; Models, Theoretical ; Reference Values

Monochorionic pregnancies have placental anastomoses that to varying degree create a common circulation. This presents unique challenges for the performance of selective termination in cases of acardiac twin, twin to twin transfusion syndrome, or discordant twin abnormalities. Multiple methods of interrupting the affected twin's circulation have been attempted with variable success.
Female ; Fetofetal Transfusion ; Humans ; Pregnancy