Four Cases of Fetomaternal Transfusion Syndrome

Abstract

We investigated the relationship between neonatal blood hemoglobin (Hb) and period of oxygen administration in 4 cases of fetomaternal transfusion syndrome at our hospital. The hematological parameters were as follows. Case 1: Hb 7.0 g/dL, reticulocyte count 177‰, no blood transfusion, and oxygen administration for 3 days. Case 2: Hb 4.7 g/dL, reticulocyte count 132‰, blood transfusion given, and oxygen administration for 7 days. Case 3: Hb 4.1 g/dL, reticulocyte count 202‰, blood transfusion given, and oxygen administration for 12 days. Case 4: Hb 3.6 g/dL, reticulocyte count 48‰, and blood transfusion given. In Case 4, we started artificial respiration and oxygen administration for treatment of neonatal asphyxia. Oxygen administration was stopped at 50 days of age. Artificial respiration was continued, and tracheostomy was attempted at 198 days of age. Case 4 was classified as having acute blood loss based on the reticulocyte count and had a poorer prognosis than Cases 1-3, which were classified as having chronic blood loss. In Cases 1-3, peripheral blood Hb level was inversely related to the period of oxygen administration.