MASSIVE FETOMATERNAL HEMORRHAGE TREATED WITH SERIAL COMBINED INTRAVASCULAR AND INTRAPERITONEAL FETAL TRANSFUSIONS

One of the many causes of fetal hydrops is fetomaternal hemorrhage. Th is report presents a pregnancy with fetomaternal hemorrhage that was t reated with serial combined intravascular and intraperitoneal fetal tr ansfusions, resulting in a good outcome. A 26-year-old woman seen for ultrasonographic evaluation was found to have a fetus with hydrops fet alis. Fetal blood sampling demonstrated severe fetal anemia (hematocri t 16.4%). The initial Kleihauer-Betke test result on maternal blood wa s 6% fetal cells. The fetus was transfused five times over a 24-day pe riod by means of a combined intravascular and intraperitoneal route. T he fetus also received one platelet transfusion for thrombocytopenia. The pregnancy resulted in a good fetal outcome without the need for po stpartum transfusion. This case represents successful treatment of fet al anemia and nonimmune hydrops with a serial combined intravascular a nd intraperitoneal transfusion technique.