{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,19]],"date-time":"2026-06-19T04:04:47Z","timestamp":1781841887083,"version":"3.54.5"},"reference-count":23,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,9,22]],"date-time":"2025-09-22T00:00:00Z","timestamp":1758499200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pediatr."],"abstract":"<jats:p>Fetomaternal hemorrhage (FMH) is a rare perinatal condition characterized by the transplacental transfer of fetal erythrocytes into the maternal circulation. It poses significant risks, including fetal anemia, hydrops fetalis, and maternal alloimmunization, and often remains underdiagnosed due to non-specific clinical presentations and limited diagnostic accessibility. We present a case of a term neonate delivered via cesarean section at 38 weeks\u2019 gestation who exhibited severe anemia and hyperbilirubinemia. Blood group analysis revealed maternal\u2013neonatal Rh incompatibility, while flow cytometry quantified 2.0% fetal erythrocytes in maternal blood. This case underscores the diagnostic value of integrating blood group serology and flow cytometry in FMH confirmation, particularly when standard tests yield equivocal results. A multidisciplinary evaluation of the fetus is the key to early diagnosis and intervention to improve the clinical outcome of perinatal infants.<\/jats:p>","DOI":"10.3389\/fped.2025.1625557","type":"journal-article","created":{"date-parts":[[2025,9,22]],"date-time":"2025-09-22T14:48:52Z","timestamp":1758552532000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["Neonatal anemia due to spontaneous fetomaternal hemorrhage in a term neonate: a case report of an incidental finding and brief review"],"prefix":"10.3389","volume":"13","author":[{"given":"Xinxin","family":"Hao","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuyu","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chang","family":"Gao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qiushi","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,9,22]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1159\/000491788","article-title":"The recurrence risk of fetomaternal hemorrhage","volume":"45","author":"Tro\u00eca","year":"2019","journal-title":"Fetal Diagn Ther"},{"key":"B2","doi-asserted-by":"publisher","first-page":"256","DOI":"10.1097\/01.AOG.0000271212.66040.70","article-title":"Long-term prognosis for infants after massive fetomaternal hemorrhage","volume":"110","author":"Rubod","year":"2007","journal-title":"Obstet Gynecol"},{"key":"B3","doi-asserted-by":"publisher","first-page":"344","DOI":"10.1046\/j.1537-2995.1990.30490273444.x","article-title":"Fetomaternal hemorrhage: incidence, risk factors, time of occurrence, and clinical effects","volume":"30","author":"Sebring","year":"1990","journal-title":"Transfusion"},{"key":"B4","doi-asserted-by":"publisher","first-page":"595","DOI":"10.1007\/s00404-015-3686-1","article-title":"Fetomaternal hemorrhage (FMH), an update: review of literature and an illustrative case","volume":"292","author":"Maier","year":"2015","journal-title":"Arch Gynecol Obstet"},{"key":"B5","doi-asserted-by":"publisher","first-page":"128","DOI":"10.1080\/jmf.13.2.128.132","article-title":"Large fetomaternal hemorrhage: clinical presentation and outcome","volume":"13","author":"Kecskes","year":"2003","journal-title":"J Matern Fetal Neonatal Med"},{"key":"B6","doi-asserted-by":"publisher","first-page":"60","DOI":"10.1111\/trf.16710","article-title":"Fetomaternal hemorrhage: evidence from a multihospital healthcare system that up to 40% of severe cases are missed","volume":"62","author":"Carr","year":"2022","journal-title":"Transfusion"},{"key":"B7","article-title":"Kleihauer Betke test","volume-title":"StatPearls","author":"Krywko","year":"2022"},{"key":"B8","doi-asserted-by":"publisher","first-page":"86","DOI":"10.1097\/GCO.0000000000000248","article-title":"Fetomaternal hemorrhage complicated pregnancy: risks, identification, and management","volume":"28","author":"Stefanovic","year":"2016","journal-title":"Curr Opin Obstet Gynecol"},{"key":"B9","doi-asserted-by":"publisher","first-page":"3972","DOI":"10.1080\/14767058.2020.1845313","article-title":"Severe neonatal anemia affected by massive fetomaternal hemorrhage: a single-center retrospective observational study","volume":"35","author":"Tao","year":"2022","journal-title":"J Matern Fetal Neonatal Med"},{"key":"B10","doi-asserted-by":"publisher","first-page":"530","DOI":"10.1186\/s12884-023-05826-9","article-title":"Spontaneous massive fetomaternal hemorrhage: two case reports and a literature review of placental pathology","volume":"23","author":"Zheng","year":"2023","journal-title":"BMC Pregnancy Childbirth"},{"key":"B11","doi-asserted-by":"publisher","first-page":"142","DOI":"10.1177\/1093526616687652","article-title":"Placental pathologic features in fetomaternal hemorrhage detected by flow cytometry","volume":"20","author":"Lewis","year":"2017","journal-title":"Pediatr Dev Pathol"},{"key":"B12","doi-asserted-by":"publisher","first-page":"9","DOI":"10.1056\/NEJM200001063420102","article-title":"Noninvasive diagnosis by Doppler ultrasonography of fetal anemia due to maternal red-cell alloimmunization. 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