PEDIATRICS Vol. 20 No. 1 July 1957, pp. 7-12
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SHOCK IN THE NEWBORN CAUSED BY TRANSPLACENTAL HEMORRHAGE FROM FETUS TO MOTHER

Jack G. Shiller M.D.1

1 Department of Pediatrics, College of Physicians and Surgeons, Columbia University and the Babies Hospital, New York

1. A case of shock in the immediate postnatal period is presented. Its origin is believed to be in transplacental hemorrhage from fetus to mother just prior to delivery.

2. Evidence for proof of this hypothesis consists of:

a. The clinical condition of the infant.

b. An elevated concentration of bilirubin in the serum in the mother immediately post partum, with subsequent disappearance.

c. An elevated concentration of fetal hemoglobin in the mother's peripheral blood immediately post partum with subsequent disappearance.

d. A rising anti-A titer in the mother over a 3-month period post partum with subsequent fall.

e. Microscopic sections of the placenta showing nucleated erythrocytes in the maternal vascular spaces.

3. It is concluded that transplacental hemorrhage may explain shock or severe anemia in a newborn infant who does not show obvious bleeding or laboratory evidence of hemolytic disease.

4. Simple transfusion is the treatment of choice.

Submitted on November 21, 1956
Accepted on December 14, 1956