Fetomaternal hemorrhage: a clue to intraplacental choriocarcinoma and neonatal malignancy

Abstract

Fetomaternal hemorrhage (FMH) is a known cause of neonatal anemia due to fetal blood loss to the maternal circulation, occurring when the maternal-fetal barrier is disrupted. Several causes must be considered, although in most cases the etiology remains unknown. Intraplacental choriocarcinoma (ICC) is a rare entity and has been related with massive FMH, intrauterine fetal demise, severe neonatal anemia and metastatic choriocarcinoma in both mother and infant. There are 25 cases of histopathologically confirmed ICC complicated with FMH described in the literature. Because FMH occurs unexpectedly and the majority of patients with ICC are asymptomatic, this diagnosis may be missed. Once FMH is confirmed, underlying malignancy should be kept in mind. The authors present a case report of severe neonatal anemia following FMH related to ICC and highlight the importance of serum β-hCG monitoring in cases of massive FMH.

Keywords:

• β-hCG
• fetomaternal hemorrhage
• infantile choriocarcinoma
• intraplacental choriocarcinoma
• severe neonatal anemia

Acknowledgements

The authors would like to thank Merlin McMillan for the revision of the manuscript.

Disclosure statement

No potential conflict of interest was reported by the author(s).