Fetomaternal hemorrhage: evaluation of recurrence within a large integrated healthcare system.

American Journal of Obstetrics and Gynecology
Marie J BollerGalen M Schauer

Abstract

Fetomaternal hemorrhage is associated with severe fetal morbidity and mortality. The recurrence risk of fetomaternal hemorrhage is unknown. We sought to establish the recurrence rate of fetomaternal hemorrhage in a large integrated healthcare system over a 10-year period. In this retrospective study within the Kaiser Permanente Northern California medical system, cases of fetomaternal hemorrhage were defined by either an elevated fetal hemoglobin level as determined by flow cytometry for a concerning pregnancy outcome (preterm delivery, perinatal demise, neonatal anemia, or transfusion within the first 2 days of life) or by perinatal demise with autopsy findings suggestive of fetomaternal hemorrhage. The outcomes of subsequent pregnancies were reviewed for features of recurrence. Within the 2008 to 2018 birth cohort of 375,864 pregnancies, flow cytometry testing for fetal hemoglobin levels was performed in 20,582 pregnancies. We identified 340 cases of fetomaternal hemorrhage (approximately 1 in 1100 births). Within the cohort of 340 affected pregnancies, perinatal loss was recorded for 80 (23.5%) pregnancies and 50 (14.7%) pregnancies delivered neonates who required transfusion. The affected patients had 225 subsequent pregnan...Continue Reading

References

Jan 1, 1989·Acta Obstetricia Et Gynecologica Scandinavica·E NordP Thomassen
Dec 15, 1985·American Journal of Obstetrics and Gynecology·P G RoseF P Zuspan
Jun 1, 1997·Obstetrical & Gynecological Survey·G P Giacoia
Apr 23, 2010·Obstetrics and Gynecology·Blair J Wylie, Mary E D'Alton
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Aug 30, 2018·Obstetrics and Gynecology·UNKNOWN American College of Obstetricians and Gynecologists' Committee on Practice Bulletins—Gynecology

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