Massive fetomaternal hemorrhage: a case series and review of literature

Objectives: Massive fetomaternal hemorrhage (FMH) is a rare and difficult to diagnose event that can have catastrophic outcomes. Although many etiologies have been associated with FMH, the majority of cases are idiopathic and affect uncomplicated pregnancies. The prevailing symptom is decreased fetal movements but some cases are asymptomatic. Changes in the fetal Doppler ultrasound, a sinusoidal cardiotocographic pattern, neonatal anemia, unexplained hydrops or stillbirth can raise suspicion that such an event has occurred. Case presentation: This article presents a case series of severe FMH diagnosed in our center between 2011 and 2020 as well as a review of the current available literature. Conclusions: We highlight the importance of the clinician's awareness on detecting this rare but potentially life-threatening event.