FETOMATERNAL HEMORRHAGE - A CAUSE FOR DEC REASING FETAL MOVEMENTS - 2CASES

Two cases of fetomaternal macrotransfusion in otherwise normal pregnan cies are reported. In both cases the main symptoms observed by the pat ients were decreasing fetal movements. Cardiotocography revealed a hig hly pathologic pattern and immediate cesarean section was performed. T he cause of massive fetomaternal hemorrhage (390 and 635 ml fetal bloo d) remains unclear. Delayed treatment leads to severe anemia followed by hypovolemic shock and ultimately to stillbirth. Pregnancies complic ated by fetomaternal hemorrhage develope normally until signs of fetal decompensation begin to appear. Decreasing fetal movements in the mos t common symptom reported by the patients. In addition to a contractio n-stress-test, blood from the pregnant women should be looked at for f etal erythrocytes, a test that can be performed very quickly and easil y. If the fetus is viable, immediate delivery should be performed and blood transfusions to the newborn should be administered. In preterm p regnancies cordocentesis and intrauterine bloodtransfusion may be cons idered.