fetomaternal transfusion


Summary: Transplacental passage of fetal blood into the circulation of the maternal organism. (Dorland, 27th ed)

Top Publications

  1. Iyer R, McElhinney B, Heasley N, Williams M, Morris K. False positive Kleihauer tests and unnecessary administration of anti-D immunoglobulin. Clin Lab Haematol. 2003;25:405-8 pubmed
    ..The case highlights the importance of a high index of clinical suspicion for HPFH and the importance of access to flow cytometry estimation of minor RhD red cell populations postnatally in RhD-negative mothers. ..
  2. Kjaer D, Sørensen T, Knudsen H. [Decreased fetal movements and massive fetomaternal transfusion]. Ugeskr Laeger. 2004;166:3826-7 pubmed
  3. Faridi A, Rath W. [Differential diagnosis of thrombocytopenia in pregnancy]. Zentralbl Gynakol. 2001;123:80-90 pubmed
    ..During pregnancy, TTP usually presents in the second trimester, whereas HUS develops in the postpartum period. Heparin-induced thrombocytopenia type II is a serious, immune-mediated complication of heparin therapy. ..
  4. Lubusky M, Simetka O, Studnicková M, Prochazka M, Feketevíziová L, Ordeltova M, et al. [Fetomaternal haemorrhage in delivery by cesarean section]. Ceska Gynekol. 2012;77:156-62 pubmed
    ..Contrarily, only rarely does greater FMH occur and delivery by cesarean section does not present a risk factor. ..
  5. Malcus P, Bjorklund L, Lilja M, Teleman P, Laurini R. Massive feto-maternal hemorrhage: diagnosis by cardiotocography, Doppler ultrasonography and ST waveform analysis of fetal electrocardiography. Fetal Diagn Ther. 2006;21:8-12 pubmed
    ..The diagnosis of a massive feto-maternal hemorrhage was confirmed by an extremely high fraction of erythrocytes containing fetal hemoglobin in maternal blood and, after delivery, by placental histology. ..
  6. Bucher C, Stern M, Buser A, Heim D, Paulussen M, Halter J, et al. Role of primacy of birth in HLA-identical sibling transplantation. Blood. 2007;110:468-9 pubmed
  7. Dziegiel M, Nielsen L, Berkowicz A. Detecting fetomaternal hemorrhage by flow cytometry. Curr Opin Hematol. 2006;13:490-5 pubmed
    ..Fetal hemoglobin for detection of fetomaternal hemorrhage is an accurate clinical diagnostic procedure for investigation of anemia in fetus and newborn. ..
  8. Kim Y, Makar R. Detection of fetomaternal hemorrhage. Am J Hematol. 2012;87:417-23 pubmed publisher
    ..Hematology analyzers with flow cytometry capabilities may be adapted for fetal cell detection, thus giving clinical laboratories a potentially attractive automated alternative for quantifying FMH. ..
  9. Kumpel B. Labeling D+ RBCs for flow cytometric quantification of fetomaternal hemorrhage after the RBCs have been coated with anti-D. Transfusion. 2001;41:1059-63 pubmed
    ..As the testing laboratory may not know if the patient has received prophylactic RhIg, this labeling method would be suitable for all samples. ..

More Information


  1. Wong L, Hunsberger B, Bruce Bagwell C, Davis B. Automated quantitation of fetomaternal hemorrhage by flow cytometry for HbF-containing fetal red blood cells using probability state modeling. Int J Lab Hematol. 2013;35:548-54 pubmed publisher
    ..Thus, PSM provides a means to markedly improve interlaboratory variance with FMH assays based upon subjective gating strategies. ..
  2. Gielezynska A, Fabijańska Mitek J, Debska M. [Calculation of feto-maternal haemorrhage volume using various morphological parameters and various formulas]. Pol Merkur Lekarski. 2011;30:228-30 pubmed
    ..The formula with individual maternal and foetal morphological parameters is much more accurate for calculation of the volume of FMH and doses of anti-RhD Ig than often used formula with average values of the parameters. ..
  3. Cha D, Hogan B, Bohmer R, Bianchi D, Johnson K. A simple and sensitive erythroblast scoring system to identify fetal cells in maternal blood. Prenat Diagn. 2003;23:68-73 pubmed
    ..In addition, these defined parameters may serve as computational classifiers for the automated detection of fetal cells in maternal blood. ..
  4. Subira D, Uriel M, Serrano C, Castañón S, Gonzalo R, Illán J, et al. Significance of the volume of fetomaternal hemorrhage after performing prenatal invasive tests. Cytometry B Clin Cytom. 2011;80:38-42 pubmed publisher
    ..015% and <0.05%, should be carefully considered depending on the week of gestation. Data obtained before 15 weeks might reflect previous cell trafficking between fetus and mother instead of acute hemorrhage. ..
  5. Kolialexi A, Tsangaris G, Antsaklis A, Kitsiou Tzeli S, Mavrou A. Use of annexin V for the identification of fetal cells in maternal circulation. In Vivo. 2004;18:629-32 pubmed
    ..3% and no fetal cells were detected. Accurate estimation of the proportion of fetal cells undergoing apoptosis may facilitate the optimization of protocols for non-invasive prenatal diagnosis of chromosomal abnormalities. ..
  6. Zizka Z, Fait T, Belosovicova H, Haakova L, Mara M, Jirkovska M, et al. ABO fetomaternal compatibility poses a risk for massive fetomaternal transplacental hemorrhage. Acta Obstet Gynecol Scand. 2008;87:1011-4 pubmed publisher
    ..A tertiary care center. Sample and methods. Between 2003 and 2007, we evaluated eight cases of severe fetomaternal transfusion. The Kleihauer-Betke test was used for diagnosis of fetomaternal hemorrhage...
  7. Lafferty J, Raby A, Crawford L, Linkins L, Richardson H, Crowther M. Fetal-maternal hemorrhage detection in Ontario. Am J Clin Pathol. 2003;119:72-7 pubmed
  8. Defendenti C, Atzeni F, Spina M, Grosso S, Cereda A, Guercilena G, et al. Clinical and laboratory aspects of Ro/SSA-52 autoantibodies. Autoimmun Rev. 2011;10:150-4 pubmed publisher
    ..However, the majority of the specific diagnosis is mostly based on the simultaneous presence of other autoantibodies that seems diagnostically more relevant. ..
  9. Thomas A, Mathew M, Unciano Moral E, Vaclavinkova V. Acute massive fetomaternal hemorrhage: case reports and review of the literature. Acta Obstet Gynecol Scand. 2003;82:479-80 pubmed
  10. Oxford C, Ludmir J. Trauma in pregnancy. Clin Obstet Gynecol. 2009;52:611-29 pubmed publisher
    ..A clear understanding of gestational age and fetal viability should be documented in the record. ..
  11. Meleti D, de Oliveira L, Araujo Júnior E, Caetano A, Boute T, Nardozza L, et al. Evaluation of passage of fetal erythrocytes into maternal circulation after invasive obstetric procedures. J Obstet Gynaecol Res. 2013;39:1374-82 pubmed publisher
    ..Invasive obstetric procedures performed during prenatal care are safe when performed by experienced professionals with the proper technique, with minimal chance of passage of fetal erythrocytes into the maternal compartment. ..
  12. Khoo C, Bollapragada S, Mackenzie F. Massive fetomaternal hemorrhage following failed external cephalic version: case report. J Perinat Med. 2006;34:250-1 pubmed
  13. Lo Y, Chiu R. The biology and diagnostic applications of plasma RNA. Ann N Y Acad Sci. 2004;1022:135-9 pubmed
    ..This discovery has created new prenatal diagnostic and monitoring possibilities. It is expected that circulating RNA will find application in many other clinical scenarios, including emergency medicine. ..
  14. Ohto H, Miura S, Ariga H, Ishii T, Fujimori K, Morita S. The natural history of maternal immunization against foetal platelet alloantigens. Transfus Med. 2004;14:399-408 pubmed
    ..No cases of intracranial bleeding or death due to FMAIT were recorded. Generalized purpura due to FMAIT occurs in one in 9359 (95% CI: 1 in 77 519-1 in 2591) pregnancies solely because of HPA-4b incompatibility. ..
  15. Avent N. Antenatal genotyping of the blood groups of the fetus. Vox Sang. 1998;74 Suppl 2:365-74 pubmed
  16. Burastero S, Galbiati S, Vassallo A, Sabbadini M, Bellone M, Marchionni L, et al. Cellular microchimerism as a lifelong physiologic status in parous women: an immunologic basis for its amplification in patients with systemic sclerosis. Arthritis Rheum. 2003;48:1109-16 pubmed
    ..In SSc patients, cellular microchimerism is accounted for by a higher number of cells that have the characteristics of T lymphocytes specific to maternal allogeneic antigens. ..
  17. al Mufti R, Hambley H, Farzaneh F, Nicolaides K. Fetal erythroblasts in maternal blood in relation to gestational age. J Matern Fetal Neonatal Med. 2003;14:392-7 pubmed
    ..6% and 1.5% at 11 weeks to zero after 19 weeks and 24 weeks. In normal singleton pregnancy the percentage of fetal erythroblasts enriched from maternal blood decreases with gestation. ..
  18. Kolialexi A, Tsangaris G, Antsaklis A, Mavroua A. Rapid clearance of fetal cells from maternal circulation after delivery. Ann N Y Acad Sci. 2004;1022:113-8 pubmed
  19. McGrath H. Elective pregnancy termination and microchimerism: comment on the article by Khosrotehrani et al. Arthritis Rheum. 2004;50:3058-9; author reply 3059 pubmed
  20. O Donoghue K, Choolani M, Chan J, de la Fuente J, Kumar S, Campagnoli C, et al. Identification of fetal mesenchymal stem cells in maternal blood: implications for non-invasive prenatal diagnosis. Mol Hum Reprod. 2003;9:497-502 pubmed
    ..We speculate that gender microchimerism in post-reproductive maternal tissues might result from feto-maternal trafficking of MSC in early pregnancy. ..
  21. Ulander V, Ammälä P, Sjöberg J, Lehtovirta P. [Massive fetomaternal bleeding--an insidious and serious pregnancy complication]. Duodecim. 2002;118:621-4 pubmed
  22. Wilcock F, Kadir R. Fetomaternal haemorrhage--a cause for unexplained neonatal death, presenting with reduced fetal movements and non-reactive fetal heart trace. J Obstet Gynaecol. 2004;24:456-7 pubmed
  23. Wataganara T, LeShane E, Chen A, Sullivan L, Peter I, Borgatta L, et al. Circulating cell-free fetal nucleic acid analysis may be a novel marker of fetomaternal hemorrhage after elective first-trimester termination of pregnancy. Ann N Y Acad Sci. 2004;1022:129-34 pubmed
    ..Measurement of cell-free fetal nucleic acid levels in maternal plasma may have clinical application as a novel marker of FMH after 9 weeks of gestation. ..
  24. Scholz C, Kachler A, Hermann C, Weissenbacher T, Toth B, Friese K, et al. Flowcytometric assessment of fetomaternal hemorrhage during external cephalic version at term. J Perinat Med. 2009;37:334-7 pubmed publisher
    ..Using a sensitive and accurate flow cytometric test method, our data provide further assurance to mothers on the safety of ECV at term. ..
  25. Larsen R, Berkowicz A, Lousen T, Hedegaard M, Clausen F, Krog G, et al. Massive fetomaternal hemorrhage: clearance of fetal red blood cells after intravenous anti-D prophylaxis monitored by flow cytometry. Transfusion. 2008;48:1707-12 pubmed publisher
    ..Simultaneous measurements of fetal reticulocytes and fetal RBCs in maternal blood may establish the timing of an FMH. ..
  26. Nelson M, Zarkos K, Popp H, Gibson J. A flow-cytometric equivalent of the Kleihauer test. Vox Sang. 1998;75:234-41 pubmed
    ..The flow-cytometric method may serve to replace the traditional Kleihauer test since it appears to offer improved accuracy and objectivity. ..
  27. Schmolling J, Feodorovici C, Ulrich U, Richter O. [Fetomaternal macrotransfusion after attempted external version]. Z Geburtshilfe Neonatol. 2001;205:200-3 pubmed
    ..The Kleihauer-Betke test is the method of choice to diagnose fetomaternal macrotransfusion. ..
  28. Gessoni G, Valverde S, Giacomini A, Antico F, Salvadego M, Arreghini N, et al. [Foetal-maternal alloimmunizations in the South-East area of the Venice province]. Minerva Ginecol. 2002;54:333-8 pubmed
    ..In the authors' experience the great majority of foetal-maternal alloimmunizations were clinically silent, only 6 cases (1.3% of patients with a positive DAT) needed transfusional therapy. ..
  29. Pelikan D, Scherjon S, Kanhai H. The incidence of large fetomaternal hemorrhage and the Kleihauer-Betke test. Obstet Gynecol. 2006;107:206-7; author reply 207 pubmed
  30. Kecskes Z. Large fetomaternal hemorrhage: clinical presentation and outcome. J Matern Fetal Neonatal Med. 2003;13:128-32 pubmed
    ..Adverse outcome amongst neonates with large fetomaternal hemorrhage is high. Outcome is better predicted by initial hemoglobin than volume of hemorrhage as per the Kleihauer test. ..
  31. Dhanraj D, Lambers D. The incidences of positive Kleihauer-Betke test in low-risk pregnancies and maternal trauma patients. Am J Obstet Gynecol. 2004;190:1461-3 pubmed
    ..Therefore, the presence of a positive KB test alone does not necessarily indicate pathologic fetal-maternal hemorrhage in patients with trauma. ..
  32. Galbiati S, Foglieni B, Travi M, Curcio C, Restagno G, Sbaiz L, et al. Peptide-nucleic acid-mediated enriched polymerase chain reaction as a key point for non-invasive prenatal diagnosis of beta-thalassemia. Haematologica. 2008;93:610-4 pubmed publisher
    ..Among these, 27/28 were also confirmed by direct sequencing and 4 by pyrosequencing. ..
  33. Emin L, Izard A, Schiavone S, Kermanach P, Deramecourt M, Duclusaud A, et al. [Fetomaternal transfusion and diagnosis of gestational choriocarcinoma]. Gynecol Obstet Fertil. 2015;43:250-2 pubmed publisher
    Choriocarcinoma is a rare but agressive malignant trophoblastic neoplasm. Fetomaternal transfusion can be the first sign of choriocarcinoma...
  34. Dziegiel M, Koldkjaer O, Berkowicz A. Massive antenatal fetomaternal hemorrhage: evidence for long-term survival of fetal red blood cells. Transfusion. 2005;45:539-44 pubmed
    ..ABO-compatible fetal RBCs from an FMH had a life span in the maternal circulation close to that of adult RBCs. ..
  35. Shankar M, Gough G, Chakravarti S, Vellacott I. Massive feto-maternal haemorrhage with good perinatal outcome following failed external cephalic version. Fetal Diagn Ther. 2004;19:68-71 pubmed
    ..External cephalic version is useful in the management of breech presentations at term, but it is not without risks and clinicians need to be aware of this. ..
  36. Pelikan D, Scherjon S, Kanhai H. The incidence of large fetomaternal hemorrhage and the Kleihauer-Betke test. Obstet Gynecol. 2005;106:642-3; author reply 643 pubmed
  37. Grey D, Davies J, Connolly M, Fong E, Erber W. The role of RhD agglutination for the detection of weak D red cells by anti-D flow cytometry. Clin Lab Haematol. 2005;27:127-33 pubmed
    ..Monitoring RhD agglutination and flow cytometric peak separation are pivotal if anti-D flow cytometry is to be maintained as the primary technique for FMH quantitation in the routine laboratory. ..
  38. Howarth D, Robinson F, Williams M, Norfolk D. A modified Kleihauer technique for the quantification of foetomaternal haemorrhage. Transfus Med. 2002;12:373-8 pubmed
    ..The modified technique has been used routinely in our laboratory for 3 years, during which time our performance in the UK National External Quality Assurance Scheme for FMH has been uniformly satisfactory. ..
  39. Errando C. [Severe injury in the obstetric patient: considerations for anesthesiologist and critical care specialist]. Rev Esp Anestesiol Reanim. 2005;52:336-48, 366 pubmed
    ..We review the epidemiology, etiology, treatment, and prognosis of severe or moderately severe injuries in obstetric patients. ..
  40. Debiec H, Nauta J, Coulet F, van der Burg M, Guigonis V, Schurmans T, et al. Role of truncating mutations in MME gene in fetomaternal alloimmunisation and antenatal glomerulopathies. Lancet. 2004;364:1252-9 pubmed
    ..We aimed to investigate whether the disease could affect other families, to search for mutations in the metallomembrane endopeptidase (MME) gene for NEP, and to analyse the outcome of the antenatal renal insult...
  41. Sikovanyecz J, Horvath E, Wayda K, Gellen J, Pal A, Szabo J. Increased nuchal translucency and decreased fetomaternal transfusion after chorionic villus sampling. Ultrasound Obstet Gynecol. 2003;21:455-8 pubmed
    To investigate the relationship between nuchal translucency (NT) and fetomaternal transfusion (FMT) after chorionic villus sampling (CVS)...
  42. Sifakis S, Koukoura O, Konstantinidou A, Kikidi K, Prezerakou M, Kaminopetros P. Sonographic findings in severe fetomaternal transfusion. Arch Gynecol Obstet. 2010;281:241-5 pubmed publisher
    Fetomaternal hemorrhage (FMH) or fetomaternal transfusion syndrome is the leakage of fetal red blood cells into the maternal circulation. Massive FMH can cause substantial fetal morbidity and mortality...
  43. Poole J, Daniels G. Blood group antibodies and their significance in transfusion medicine. Transfus Med Rev. 2007;21:58-71 pubmed
    ..However, deciding on the clinical significance of an antibody when compatible blood is not immediately available is likely to remain as one of the most common dilemmas facing transfusion practitioners. ..
  44. Touboul C, Faivre E, Boithias C, Mass A, Senat M, Fernandez H, et al. [Fetomaternal hemorrhage caused by intraplacental choriocarcinoma]. J Gynecol Obstet Biol Reprod (Paris). 2010;39:156-8 pubmed publisher
    ..We suggest that a pathological examination of the placenta should be performed in any case of fetomaternal hemorrhage in order to avoid misdiagnosis of intraplacental choriocarcinoma. ..
  45. Hermann M, Poissonnier M, Grange G, Bernaux M, Lefevre M, Tsatsaris V, et al. [Use of peak systolic velocity in the middle cerebral artery after serial intravenous fetal exchange transfusions in the end of pregnancy]. J Gynecol Obstet Biol Reprod (Paris). 2011;40:675-81 pubmed publisher
    ..Cerebral Doppler is useful for the follow-up of pregnancies at risk for anemia even in the end of the pregnancy and after serial intravenous fetal exchange transfusions. ..
  46. Lam C, Wong S, Lee K, Ho L, Yu V. Massive feto-maternal hemorrhage: an early presentation of women with gestational choriocarcinoma. Acta Obstet Gynecol Scand. 2002;81:573-6 pubmed
  47. Bloch E, Jackman R, Lee T, Busch M. Transfusion-associated microchimerism: the hybrid within. Transfus Med Rev. 2013;27:10-20 pubmed publisher
    ..Furthermore, microchimerism provides a tool to further our understanding of immune tolerance and regulation. ..
  48. Ponnusamy S, Mohammed N, Ho S, Zhang H, Chan Y, Ng Y, et al. In vivo model to determine fetal-cell enrichment efficiency of novel noninvasive prenatal diagnosis methods. Prenat Diagn. 2008;28:494-502 pubmed publisher
    ..65). Our data demonstrate that maternal blood obtained immediately post-TOP would be a good in vivo model to determine the enrichment efficiency of novel protocols and methods for noninvasive prenatal diagnosis. ..
  49. Sueters M, Arabin B, Oepkes D. Doppler sonography for predicting fetal anemia caused by massive fetomaternal hemorrhage. Ultrasound Obstet Gynecol. 2003;22:186-9 pubmed
    ..A Cesarean section was performed within a few hours. Both neonates were severely anemic and received immediate blood transfusions. They are currently alive and well. ..
  50. Miura K, Yoshiura K, Miura S, Yamasaki K, Nakayama D, Ishimaru T, et al. Cell-free DNA is more sensitive than cell-free mRNA as a marker for evaluation of fetal-maternal hemorrhage. Clin Chem. 2006;52:2121-3 pubmed
  51. Chou H, Chen R, Yau K, Huang S, Ni Y, Tang J. Infantile choriocarcinoma with idiopathic massive fetomaternal hemorrhage. Med Pediatr Oncol. 2002;38:203-4 pubmed
  52. Wataganara T, Chen A, LeShane E, Sullivan L, Borgatta L, Bianchi D, et al. Cell-free fetal DNA levels in maternal plasma after elective first-trimester termination of pregnancy. Fertil Steril. 2004;81:638-44 pubmed
    ..Continued elevation of fDNA for several days may occur following medical termination. ..
  53. Lubusky M, Simetka O, Studnickova M, Prochazka M, Ordeltova M, Vomackova K. Fetomaternal hemorrhage in normal vaginal delivery and in delivery by cesarean section. Transfusion. 2012;52:1977-82 pubmed publisher
    ..Contrarily, only rarely does greater FMH occur and delivery by cesarean section does not present a risk factor. ..