Fetal-maternal hemorrhage may be a normal part of pregnancy, but it can also lead to serious complications. In this article, we’ll define the term “fetal-maternal hemorrhage” and explain how it relates to birth injury law.

Key Takeaways

• Fetal-maternal hemorrhage is the loss of fetal blood cells in the parent’s circulation
• Fetal-maternal hemorrhage may be normal or abnormal
• Fetal-maternal hemorrhage can be diagnosed through a Kleihauer–Betke test or a flow cytometry test
• Treatments for fetal-maternal hemorrhage include immediate delivery and blood transfusion
• If a doctor’s negligent response to fetal-maternal hemorrhage causes birth injury or stillbirth, it may be considered medical malpractice 

What Is Fetal-Maternal Hemorrhage?

Fetal-maternal hemorrhage is when fetal blood cells are lost in the blood circulation of the pregnant parent. It can take place in normal pregnancies, but also may indicate complications. 

Typically, maternal blood circulation and fetal blood circulation are kept from direct contact with each other, and the exchange of gas and nutrients occurs only across a membrane in the placenta. When the membrane stops working as a barrier and fetal cells come in contact with or enter the maternal blood vessels, it is called fetal-maternal hemorrhage. 

Types of Fetal-Maternal Hemorrhage

There are two types of fetal-maternal hemorrhage:

• Normal - During normal labor, it is estimated that less than one milliliter of fetal blood is lost to the maternal circulation in about 96% of deliveries. While this is normal, it can stimulate antibody production to the fetal red blood cells and cause issues such as Rhesus disease, a condition where antibodies in a pregnant person's blood destroy the baby's blood cells.
• Abnormal - Up to 30 milliliters of fetal-maternal transfusion can take place without complications. However, more than this amount of loss can result in morbidity and even fetal death. 

Diagnosing Fetal-Maternal Hemorrhage

Fetal-maternal hemorrhage can be diagnosed through a test called the Kleihauer–Betke test, a blood test that measures the amount of fetal hemoglobin transferred from a fetus to the pregnant parent’s bloodstream. The result is calculated as a percentage of fetal to maternal cells. 

Another tool that can diagnose fetal-maternal hemorrhage is flow cytometry, a lab test in which a sample of cells is suspended in fluid and analyzed. 

Treatment of Fetal-Maternal Hemorrhage

If fetal-maternal hemorrhage is ongoing and rapid, it may be required to deliver the fetus immediately. If the hemorrhage has stopped, doctors may recommend a transfusion of red blood cells to the fetus in utero.

Fetal-Maternal Hemorrhage and Birth Injury Law

Because fetal-maternal hemorrhage can potentially lead to birth injury and even stillbirth, it’s critical that doctors work to detect it early and treat it quickly. Unfortunately, the symptoms of fetal-maternal hemorrhage, including feelings of weakness, lower abdominal pain, and other symptoms of anemia, can be hard to identify. 

If a healthcare provider notices the symptoms of fetal-maternal hemorrhage and fails to take action, and the fetus is injured as a result, it may be considered medical malpractice. If your doctor did not properly respond to fetal-maternal hemorrhage causing birth injury to your baby, you may be eligible for compensation. It is recommended that you speak to an experienced birth injury lawyer to review your options.