Transplacental bleeding from the foetus.

The suggestion that the foetus can become severely anaemic from haemorrhage into the maternal circulation was first made by Wiener (1948). A case reported by Wickster (1952) was almost certainly due to such a haemorrhage. However, neither Wiener nor Wickster made confirmatory laboratory tests, and it was Chown (1954, 1955) who first proved, both serologically and by showing excess of alkali-resistant haemoglobin, the presence of foetal cells in the blood of a woman just delivered of an anaemic child. A case in which anaemia was slight, but serological evidence strong, was reported by Dunsford (1957). The presence in the maternal blood of an excess of alkali-resistant haemoglobin without serological tests has been interpreted as an indication of transplacental bleeding by Colebatch, Pitt, and Maddison (1956) and by O'Connor, Shields, Kohl, and Sussman (1957). Two cases are described here of neonatal anaemia in which foetal cells were demonstrated in the maternal blood by differential agglutination and other tests. The first infant had severe haemolytic disease; the second severe anaemia which appeared to be due entirely to transplacental bleeding.