Author/Editor		Domazet-Fink, Jadranka; Pestevšek, Maja; Novak-Antolič, Živa
Title		Fetomaternalna krvavitev - diferencialna diagnostika ob prikazu primera
Translated title		Fetomaternal haemorrhage - differential diagnosis - case report
Type		članek
Source		Zdrav Vestn
Vol. and No.		Letnik 71, št. 7-8
Publication year		2002
Volume		str. 425-8
Language		slo
Abstract		Background. There are several different causes for fetomaternal haemorrhage. Sinusoidal pattern, which is relatively characteristic for fetal anaemia, may in its find stages completely disappear. Differential diagnosis of silent trace of cardiotocogram with late decelerations is quite difficult to solve. Case report. A case of unusual injury of a pregnant woman is described. The injury led to fetomaternal haemorrhage. Typical sinusoidal pattern cardiotocogram was not seen and the differential diagnosis was hard to determine. Because of prompt intervention and efficient postnatal therapy the child and mother are both well. The dilemmas in regards to differential diagnosis are being discussed. Conclusions. it is important to be very careful in history taking even if the situation is urgent. If there is no explanation for pathological cardiotocogram, decision must be made according to pregnant womans wishes. Kleihauer-Betke test, which is easy to perform and gives much information, is described.
Summary		Izhodišča. Fetomaternalna krvavitev ima lahko različne vzroke. Zanjo je razmeroma značilna sinusoidna krivulja v kardiotokogramu. Pozno v razvoju anemije ploda pa te značilnosti ni več; silenten kardiotokografski zapis s poznimi deceleracijami pa je diferencialnodiagnostično težko rešljiv. Prikaz primera. Prikazan je primer nosečnice, pri kateri je po neobičajni poškodbi prišlo do fetomaternalne krvavitve. Diferencialna diagnoza je bila težka, ker ni bilo tipičnega kardiotokografskega zapisa, značilnega za anemijo ploda. Zaradihitrega ukrepanja in učinkovitega zdravljenja otroka je bil izid za mater in otroka dober. Opisane so diferencialnodiagnostične dileme. Zaključki. Primer prikazuje, kako zelo pomembno je tudi v časovni stiski vzeti natančno anamnezo ter ob odsotnosti običajne patologije, ki bi razložila patološki kardiotokogram, ukrepati v skladu z željami nosečnice. Opisan je Kleihauer-Betkejev test, ki je preprost, tako da ga lahko opravijo ob minimalnih zahtevah, obenem pa da veliko informacij.
Descriptors		ABDOMINAL INJURIES MATERNAL-FETAL EXCHANGE CARDIOTOCOGRAPHY FETAL DISEASES ANEMIA ADULT PREGNANCY HEMORRHAGE