Clinical treatment analysis of severe neonatal anemia caused by massive fetomaternal hemorrhage
Objective To analyze the clinical characteristics,diagnosis and treatment of severe neonatal anemia caused by massive fetomaternal hemorrhage(FMH),aim to improve understanding and treatment capabilities of this disease.Methods We retrospectively analyzed the basic information,disease progression,treatment process,and outcomes of newborns with severe anemia due to massive FMH admitted to the neonatal intensive care unit(NICU)of Beijing Obstetrics and Gynecology Hospital,Capital Medical University,from January 2012 to December 2021.Results During the study period,39 pregnant women were diagnosed massive FMH,with an incidence rate of 0.28‰(39/140,727).Ultimately,16 newborns with severe anemia due to massive FMH were included in the study,including 8 full-term and 8 preterm infants.Among the clinical manifestations of the 16 pregnant women with massive FMH,8 exhibited reduced fetal movements,and abnormal fetal heart monitoring was observed in all cases.Among the 16 pregnant women who underwent Kleihauer-Betke acid elution tests(KB tests),14 were positive,and 2 were negative(with KB test values of 2.3％and 1.2％,respectively).Among the 16 newborns,15 were born via emergency cesarean section,and 1 was delivered vaginally.Initial hemoglobin(Hb)levels at birth ranged from 20 to 70 g/L.15 newborns received blood transfusion therapy after birth,while 1 did not due to treatment refusal by the family.Among them,4 cases were complicated by grade 2 intracranial hemorrhage,2 cases by severe neonatal thrombocytopenia,1 case by hemorrhagic shock,and 1 case by pleural and abdominal effusion and heart failure.2 cases discontinued treatment due to poor prognosis consideration by the family,while the remaining 14 cases had a good prognosis.Conclusion Massive FMH is one of the causes of severe anemia in newborns.Strengthening assessment and education on fetal movements in pregnant women,timely fetal heart monitoring in late pregnancy,early detection,and management of massive FMH,as well as emergency blood transfusion in newborns,are crucial for improving perinatal outcomes.
万方数据
维普
