Feto-maternal haemorrhage in Kenya.

Abstract

Six hundred and twenty antenatal, 40 post normal delivery 40 post caesarian section, 4 patients with placenta previa and 3 with fresh still section, 4 patients with placenta previa and 3 with fresh still births were investigated for feto maternal haemorrhage. The prevalence of feto maternal haemorrhage was 32.2% for antenatal patients, 45% for post caesarian section ones and 25% after normal delivery. All the values were higher than in Caucasian studies. Antenatal prevalence increased with gestation being 15.4% in first trimester, 29.5% in second and 38% in third trimester (p 0.05). Maternal age, parity, number of previous abortions and marital status did not influence the prevalence. Increased feto maternal haemorrhage was associated with history of vaginal bleeding or trauma but not pre-eclampsia. Feto maternal macrotransfusion was detected in 1% of antenatal patients, two patients with abruptio placenta, one with still birth and eight delivered by caesarian section. The mode of delivery did not influence the frequency but affected the volume of feto maternal transfusion. Probable changes in the timing of prophylactic anti D-gammaglobulin are discussed.