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PLASTIC RECONSTRUCTIVE AND REGENERATIVE SURGERY

Abstract

INTRODUCTION
Massive foeto-maternal transfusion (FMT) is the passage into the maternal circulation of >20% of foetal blood volume. It is associated with high perinatal morbidity and mortality1. FMT affects approximately 0.3-1:1,000 births and in non-complicated near-term pregnancies is frequently idiopathic1.Clinical manifestations are non-specific and are mostly represented by a decrease in active foetal movements (AFM). Foetal anaemia can be suggested by a sinusoidal rhythm on cardiotocography (CTG) and by high peak systolic velocity (PSV) of the middle cerebral artery (MCA); both tests, however, are liable to yield false negative results1. The conclusive diagnosis of FMT is based on maternal laboratory blood tests such as the Kleihauer-Betke, although the gold standard is currently flow cytometry which has been proven to be more sensitive and time-saving2. However, the latter test is not always available, and therefore FMT is to be considered when other possible origins of neonatal anaemia have been excluded. We aim to demonstrate the long-lasting persistence of foetal blood cells in the maternal circulation in a case of massive FMT. These data are useful in a clinical scenario when FMT is not immediately suspected or investigated. [ … ]

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Authors

Fabrizio Signore Department of Obstetrics and Gynaecology, Santo Eugenio Hospital, ASL Roma

Laura Marchi Department of Obstetrics and Gynaecology, Santo Stefano Hospital, AUSL Toscana Centro, Prato, Italy

Nathalie Conti Department of Obstetrics and Gynaecology, Misericordia Hospital, AUSL Toscana Sud Est, Prato, Italy

Cinzia Orlandini Department of Obstetrics and Gynaecology, Misericordia Hospital, AUSL Toscana Sud Est, Prato, Italy

Annalisa Vidiri Department of Woman and Child Health, Fondazione Policlinico Universitario A. Gemelli IRCCS and Università Cattolica del Sacro Cuore, Rome, Italy

Francesca Brugnolo Blood Transfusion Service, Meyer Children's Hospital, Florence, Italy

Franco Bambi Blood Transfusion Service, Meyer Children's Hospital, Florence, Italy

Simona Zaami Department of Anatomical, Histological, Forensic and Orthopaedic Sciences, “Sapienza” University of Rome, Rome, Italy

Giovanni Scambia Department of Woman and Child Health, Fondazione Policlinico Universitario A. Gemelli IRCCS and Università Cattolica del Sacro Cuore, Rome, Italy

Anna F. Cavaliere Department of Obstetrics and Gynaecology, Santo Stefano Hospital, AUSL Toscana Centro, Prato, Italy

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