Fetomaternal hemorrhage: a case highlighting the significance of multifaceted prenatal detection and timely intervention.

INTRODUCTION

Fetomaternal hemorrhage (FMH), a life-threatening obstetric complication with high concealment and poor prognosis, is mostly postnatally diagnosed.

CASE REPORT: This case reports the 30 years old primigravida at 32 + 1 weeks, preoperatively identified with FMH via combined indicators: markedly elevated maternal serum alpha-fetoprotein (AFP) (16698.2 μg/L post-dilution), decreased fetal movement, two non-reassuring fetal heart rate tracings, and polyhydramnios. Emergency cesarean section was done. The neonate had severe anemia (Hb 5.9 g/dL) and metabolic acidosis, with Hb rising to 137 g/dL after 26 mL packed red blood cell transfusion. Maternal K-B test confirmed 1.1% fetal Hb (116 mL blood loss). The neonate was discharged at 40 + 2 weeks corrected gestational age.

CONCLUSION

This case emphasizes that the integration of multiple prenatal clinical and laboratory cues facilitates early detection of FMH, thereby contributing to improved perinatal prognosis.