IDENTIFICATION OF ACUTE TRANSPLACENTAL HEMORRHAGE IN A LOW-RISK PATIENT AS A RESULT OF DAILY COUNTING OF FETAL MOVEMENTS

In this report, we describe a case of acute, massive fetomaternal hemo rrhage that was detected during the 32nd week of pregnancy by maternal perception of decreased fetal movement and suggestion of a sinusoidal heart rate pattern. Additional evaluation revealed an abnormal biophy sical profile (2 of 10) and intermittent late decelerations. Because o f the substantially decreased fetal reserve, cesarean section was emer gently performed. A 1,880-g female infant was delivered. She had an in itial hemoglobin concentration of 1.9 g/dl and a hematocrit of 5.7% bu t did well after appropriate transfusion therapy. This case confirms t he importance of daily counting of fetal movements in low-risk patient s. In addition, it emphasizes that early diagnosis and treatment of ma ssive fetomaternal hemorrhage can improve infant survival.