Keep in mind foetomaternal haemorrage in case of reduced foetal movements: a successful obstetric management

Foetomaternal blood exchange occurs in about 50–75% of pregnancies with an unclear physiopathology. Foetomaternal haemorrhage (FMH) is a poorly understood clinical condition with an incidence of between 0.3 and 1, over 1000 deliveries (Sueters et al. 2003). This clinical condition seems to be responsible for 14% of perinatal deaths of unknown cause, and several studies suggest that there is a potential link between FMH and decreased or absent foetal movements, sinusoidal foetal heart rate pattern, stillbirths and hydrops foetalis (Giacoia 1997). If this condition is suspected, the delivery and neonatal blood transfusion if necessary represent an appropriate management in addition to the Kleihauer–Betke test to confirm the diagnosis. We describe a case of FMH of unknown cause, in which reduced foetal movements were associated with severe neonatal anaemia.