~ 67 ~ International Journal of Clinical Obstetrics and Gynaecology 2019; 3(3): 67-70 ISSN (P): 2522-6614 ISSN (E): 2522-6622 © Gynaecology Journal www.gynaecologyjournal.com 2019; 3(3): 67-70 Received: 07-03-2019 Accepted: 03-04-2019 Dr. Chandrakant S Madkar Professor, Dr. D.Y. Patil, Vidyapeeth, Pune, Maharashtra, India Dr. Madhukar J Shinde Associate Professor, Dr. D.Y. Patil, Vidyapeeth, Pune, Maharashtra, India Dr. Hemant G Deshpande HOD. Professor, Dr. D.Y. Patil, Vidyapeeth, Pune, Maharashtra, India Dr. Swarna Gupta Resident, Dr. D.Y. Patil, Vidyapeeth, Pune, Maharashtra, India Dr. Apurva Singh Resident, Dr. D.Y. Patil, Vidyapeeth, Pune, Maharashtra, India Correspondence Dr. Madhukar J Shinde Associate Professor, Dr. D.Y. Patil, Vidyapeeth, Pune, Maharashtra, India Comparative study of fetomaternal hemorrhage in normal vaginal delivery and lower segment casearean section Dr. Chandrakant S Madkar, Dr. Madhukar J Shinde, Dr. Hemant G Deshpande, Dr. Swarna Gupta and Dr. Apurva Singh DOI: https://doi.org/10.33545/gynae.2019.v3.i3b.12 Abstract Background: Fetomaternal Hemorrhage has got specific importance particularly in case of haemolytic disease of the new-born. It has got special impact in patients of RH incompatibility that is RH negative mother bearing RH positive foetus. It has played a significant role in reducing the morbidity and mortality in RH incompatibility cases in past. The base of this treatment is prophylactic Anti-D injection after delivery abortion and other conditions related with FMH. The dose of this Anti-D is dependent on the quantity of FMH which can be detected by using KB Test. Material and Method: In our study we have done comparative study of FMH in cases of full term normal vaginal delivery in primigravida against lower segment caesarean section in primigravida. The sample size will be 60 in each group. The blood was collected after 2-4 hours following FTND and LSCS. The FMH was decided by KB Test and analysis of both groups was done to know whether there is significant difference. Result: Our study showed that there is no significant difference in FMH in cases of FTND and LSCS. Keywords: FMH- Fetomaternal haemorrhage HDFN-Haemolytic disease of foetus and new born KB Test- Kkeihauer-Betke test INJ. ANTI-D-Injection Anti-D 1. Introduction The placenta is considered as an ephemeral organ which acts as the interface between mother and fetus [1] . It ensures the foetus a proper supply of nutrition and safeguards the surrounding against unfavourable conditions and also secures immunological environment [2] . Both the foetal and maternal blood is differentiated by a selectively permeable ‘placental barrier [3] . However, some foetal red blood cells can disturb the placental barrier, permeate it and enters into the maternal circulation before or during the delivery posing a serious risk to the foetus resulting in foetal morbidity and mortality [4, 5] . This pathological condition is referred as fetomaternal haemorrhage (FMH). FMH is defined as the loss of foetal blood cells into the maternal circulation [6] . It is estimated that less than 1ml of foetal blood is lost to the maternal circulation during normal labor in around 96% of deliveries [6, 7] . The loss of this small amount of blood may sensitise event and stimulate antibody production to the foetal red blood cells, resulting, in anaemia, jaundice complications like hydrops fetalis, neurological injury, stillbirth or neonatal death [4] . This has got more significance in case of Rh negative mother bearing Rh positive foetus in ABO compatible blood groups of mother and foetus. However, small amount of FMH can occur in all trimesters of pregnancy through the microscopic breach in the maternal barrier which can cause sensitization before the delivery. About 3% of FMH has been observed in the first trimester, increasing to 12.1% in the second trimester, 45.5% in the final semester and 63.6% after delivery [8] . FMH is mainly concerned with the haemolytic disease of foetus and new-born (HDFN). The pathology of which is immunological sensitization in different blood groups. In practice A, B, AB and O are associated with the presence or absence of D antigen which is known by Rh positive and Rh-negative blood group respectively. There are other blood group antigens also like Lewis antigen, Kell antigen, Duffy antigen and MNS antigen, but they are rare and does not come in common practice [9] .