Gynecologie, obstetrique, fertilite & senologie · 2025
[Maternal-fetal hemorrhagia: Description of 103 cases and analysis of predictive factors of neonatal outcome].
Аннотация на английскомСтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Dietz Clara, Atallah Anthony, Guinchard Emmanuelle, Bonjean Simone-Laure, Rault Emmanuel, de la Fournière Benoit, Huissoud Cyril
Аннотация
OBJECTIVES: Maternal-fetal haemorrhage (MFH) can be responsible for anaemia and hypovolaemic shock with a life-threatening foetal/neonatal outcome. In FMH, the indications for the Kleihauer-Betke test (TKB), paraclinical monitoring and obstetric management are not standardised. The aim was to analyse the diagnostic circumstances and neonatal outcomes in cases of FMH.
METHODS: Retrospective cohort including all patients with a positive TKB performed at the EFS center between 2012 and 2020 (22,715 Tests) for two type 3 maternities after exclusion of tests to prevent rhesus immunisation. Adverse neonatal outcome was defined by a composite criterion. The volume of FMH was expressed as the volume of blood transfused relative to the estimated foetal weight or neonatal weight.
RESULTS: Among the 103 patients included, the reason for performing TKB was a decrease in active foetal movements (49.5%). FMH was <10mL/kg in 45.6% of cases and >30mL/kg (massive FMH) in 33%. In the massive FMH group there were 12 in utero deaths, and in the live foetuses, the Manning ultrasound score was normal (8/8) in 68.4% of cases, brain velocities <1.5MoM in 26.7% and normal FHR in 22.7% of cases. All live-born infants in this group survived, 78.3% were transfused and two developed neurological sequelae. The ratio of FMH volume to fetal weight was the best predictor of postnatal transfusion in the first week of life.
CONCLUSIONS: Decreased perception of fetal movements was the main reason for looking for FMH. Ultrasound-Doppler and FHR could be normal in massive FMH, even in cases of decreased perception of fetal movements.
METHODS: Retrospective cohort including all patients with a positive TKB performed at the EFS center between 2012 and 2020 (22,715 Tests) for two type 3 maternities after exclusion of tests to prevent rhesus immunisation. Adverse neonatal outcome was defined by a composite criterion. The volume of FMH was expressed as the volume of blood transfused relative to the estimated foetal weight or neonatal weight.
RESULTS: Among the 103 patients included, the reason for performing TKB was a decrease in active foetal movements (49.5%). FMH was <10mL/kg in 45.6% of cases and >30mL/kg (massive FMH) in 33%. In the massive FMH group there were 12 in utero deaths, and in the live foetuses, the Manning ultrasound score was normal (8/8) in 68.4% of cases, brain velocities <1.5MoM in 26.7% and normal FHR in 22.7% of cases. All live-born infants in this group survived, 78.3% were transfused and two developed neurological sequelae. The ratio of FMH volume to fetal weight was the best predictor of postnatal transfusion in the first week of life.
CONCLUSIONS: Decreased perception of fetal movements was the main reason for looking for FMH. Ultrasound-Doppler and FHR could be normal in massive FMH, even in cases of decreased perception of fetal movements.