{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,13]],"date-time":"2026-06-13T14:15:54Z","timestamp":1781360154486,"version":"3.54.1"},"reference-count":33,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2024,6,20]],"date-time":"2024-06-20T00:00:00Z","timestamp":1718841600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Centre of Postgraduate Medical Education","award":["501-1-026-02-20\/MG5"],"award-info":[{"award-number":["501-1-026-02-20\/MG5"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: The aim of the study was to investigate if feto-maternal transfusion was related to the size of the fetal-maternal interface, and, therefore, was larger in twin pregnancy in comparison with singleton pregnancy. Methods: Blood samples from women with singleton (n = 11), and monochorionic (n = 11) and dichorionic (n = 13) twin gestations were tested. Flow cytometry tests with hemoglobin F, glycophorin A, and hemoglobin F and carbonic anhydrase simultaneous staining were used to detect fetal red blood cells and maternal F cells. Results: In all cases, the volume of feto-maternal transfusion was estimated to be low. The highest rate of fetal red blood cells in the maternal circulation was observed in the blood of women with dichorionic twin gestations both before and after delivery. An increase in fetal red blood cells was observed after cesarean section in singletons and twins. The median rate of maternal F cells was 2.23% in singleton, 2.1% in monochorionic and 3.95% in dichorionic pregnancy. Conclusions: Feto-maternal transfusion during pregnancy may be related to the multiplicity and chorionicity of pregnancy.<\/jats:p>","DOI":"10.3390\/jcm13123609","type":"journal-article","created":{"date-parts":[[2024,6,20]],"date-time":"2024-06-20T05:27:19Z","timestamp":1718861239000},"page":"3609","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Is Feto-Maternal Transfusion after Cesarean Delivery Different in Singleton and Twin Pregnancy?"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2760-9361","authenticated-orcid":false,"given":"Anna","family":"Stachurska-Skrodzka","sequence":"first","affiliation":[{"name":"Department of Cell Biology and Immunology, Center of Postgraduate Medical Education, 01-813 Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Damian","family":"Mielecki","sequence":"additional","affiliation":[{"name":"Department of Neurochemistry, Mossakowski Medical Research Institute, Polish Academy of Sciences, 02-106 Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Fija\u0142kowska","sequence":"additional","affiliation":[{"name":"Department of Cell Biology and Immunology, Center of Postgraduate Medical Education, 01-813 Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kinga","family":"\u017bebrowska","sequence":"additional","affiliation":[{"name":"Department of Obstetrics, Perinatology and Neonatology, Center of Postgraduate Medical Education, 01-813 Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Monika","family":"Kasperczak","sequence":"additional","affiliation":[{"name":"Department of Obstetrics, Perinatology and Neonatology, Center of Postgraduate Medical Education, 01-813 Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5461-273X","authenticated-orcid":false,"given":"Katarzyna","family":"Kosi\u0144ska-Kaczy\u0144ska","sequence":"additional","affiliation":[{"name":"Department of Obstetrics, Perinatology and Neonatology, Center of Postgraduate Medical Education, 01-813 Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,6,20]]},"reference":[{"key":"ref_1","unstructured":"Mollison, P. (1979). Incidence of transplacental haemorhage. Blood Transfusion and Clinical Medicine, Blackwell Scientific Publications. [6th ed.]."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"20210079","DOI":"10.1515\/crpm-2021-0079","article-title":"Massive fetomaternal hemorrhage: A case series and review of literature","volume":"11","author":"Smet","year":"2022","journal-title":"Case Rep. Perinat. Med."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"2197096","DOI":"10.1080\/14767058.2023.2197096","article-title":"Massive fetomaternal hemorrhage in a monochorionic-diamniotic twin pregnancy: A case report","volume":"36","author":"Liao","year":"2023","journal-title":"J. Matern. Fetal Neonatal Med."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1978","DOI":"10.1111\/j.1537-2995.2011.03536.x","article-title":"Fetomaternal hemorrhage in normal vaginal delivery and in delivery by cesarean section","volume":"52","author":"Lubusky","year":"2012","journal-title":"Tranfusion"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"133","DOI":"10.1016\/j.cll.2020.10.009","article-title":"Hemolytic Disease of the Fetus and Newborn: Historical and Current State","volume":"41","author":"Jackson","year":"2021","journal-title":"Clin. Lab. Med."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"491","DOI":"10.2147\/PHMT.S327032","article-title":"Hemolytic disease of the newborn: A review of current trends and prospects","volume":"12","author":"Myle","year":"2021","journal-title":"Pediatr. Health Med. Ther."},{"key":"ref_7","unstructured":"(2024, April 10). The Management of Women with Red Cell Antibodies during Pregnancy (Green-Top Guideline No. 65). Available online: https:\/\/www.rcog.org.uk\/guidance\/browse-all-guidance\/green-top-guidelines\/the-management-of-women-with-red-cell-antibodies-during-pregnancy-green-top-guideline-no-65\/."},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"(2017). Practice Bulletin No. 181: Prevention of Rh D Alloimmunization. Obstet. Gynecol., 130, e57\u2013e70.","DOI":"10.1097\/AOG.0000000000002232"},{"key":"ref_9","first-page":"64","article-title":"Profilaktyka \u015br\u00f3dci\u0105\u017cowa i oko\u0142oporodowa konfliktu serologicznego","volume":"3","author":"Kalinka","year":"2018","journal-title":"Ginekol. I Perinatol. Prakt."},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Cardoso, M., de Souza -Aranjo, C.N., Talarico, M.C.R., Moucoucah-Heinrich, J., Guimeness, F., and Basini, R. (2019). Evaluation of atomatic blood analyzer as screening method in fetomaternal hemorrhage. BioMed Res. Int., 2019.","DOI":"10.1155\/2019\/6481654"},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Zheng, Y., Li, D., Zheng, A., and Wang, F. (2023). Spontaneous massive fetomaternal hemorrhage: Two case reports and a literature review of placental pathology. BMC Pregnancy Childbirth, 23.","DOI":"10.1186\/s12884-023-05826-9"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"187","DOI":"10.5385\/nm.2020.27.4.187","article-title":"Acute fetomaternal hemorrhage confirmed by maternal alfa-fetoprotein in monochorionic diamniotic neonates under 1500 g","volume":"27","author":"Yoo","year":"2020","journal-title":"Neonatal Med."},{"key":"ref_13","first-page":"e070101","article-title":"How to manage fetomaternal hemorrhage? Description of five cases and literatur\u0119 review","volume":"7","author":"Marciano","year":"2018","journal-title":"J. Pediatr. Neonatal Individ. Med."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"409","DOI":"10.1111\/j.1365-2257.2006.00884.x","article-title":"Evaluation of F cells in sickle cel disorders by flow cytometry -comparison with the Kleihauer\u2014Betke slide method","volume":"29","author":"Italia","year":"2007","journal-title":"Int. J. Lab. Hematol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1002\/cyto.b.21052","article-title":"Evaluation of FMH QuikQuant for the detection and quantification of fetomaternal hemorrhage","volume":"84","author":"Pastoret","year":"2013","journal-title":"Cytometry"},{"key":"ref_16","first-page":"570","article-title":"The prevalence of maternal F cells in a pregnant population and potential overestimation of foeto-maternal haemorrhage as a consequence","volume":"12","author":"Corcoran","year":"2014","journal-title":"Blood Transfus."},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Li, X., and Yin, M. (2023). Prenatal diagnosis of fetomaternal hemorrhage by a novel hydrogel fluoroimmunoassay that accurately quantifies fetal haemoglobin. Front. Bioeng. Biotechnol., 11.","DOI":"10.3389\/fbioe.2023.1194704"},{"key":"ref_18","doi-asserted-by":"crossref","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":"ref_19","doi-asserted-by":"crossref","first-page":"333","DOI":"10.1111\/j.1537-2995.1971.tb04424.x","article-title":"Studies on Rh prophylaxis. 1. Relationship between doses of anti-Rh and size of antigenic stimulus","volume":"11","author":"Pollack","year":"1971","journal-title":"Transfusion"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"540","DOI":"10.1016\/j.ajog.2021.04.257","article-title":"Fetomaternal hemorrhage: Evaluation of recurrence within a large integrated healthcare system","volume":"225","author":"Boller","year":"2021","journal-title":"Am. J. Obstet. Gynecol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1159\/000491788","article-title":"The recurrence risk of fetomaternal hemorrhage","volume":"45","author":"Troia","year":"2019","journal-title":"Fetal Diagn. Ther."},{"key":"ref_22","first-page":"323","article-title":"Massive fetomaternal hemorrhage: Manitoba experience","volume":"83","author":"Bowman","year":"1994","journal-title":"Obstet. Gynecol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"60","DOI":"10.1080\/01443610701812181","article-title":"Feto-maternal haemorhage in partrients: Incidence and its determinants","volume":"28","author":"Adeniji","year":"2008","journal-title":"J. Obstet. Gynaecol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"254","DOI":"10.1515\/JPM.2004.047","article-title":"Risk factors for fetal-to-maternal transfusion in RhD- negative women-results of a prospective study on 942 pregnant women","volume":"32","author":"David","year":"2004","journal-title":"J. Perinat. Med."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1039","DOI":"10.1097\/01.AOG.0000157115.05754.3c","article-title":"The incidence of large fetomaternal hemorrhage and the Kleihauer-Betke test","volume":"105","author":"Salim","year":"2005","journal-title":"Obstet. Gynecol."},{"key":"ref_26","first-page":"7","article-title":"Fetal-maternal hemorrhage: A case and literature review","volume":"2","author":"Solomonia","year":"2012","journal-title":"AJP Rep."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1016\/j.contraception.2022.02.001","article-title":"Fetomaternal hemorrhage assesment in Rh\u2014Negative patients undrrgoing dilation and evacuation between 20 and 24 weeks\u2019 gestational age: A retrospective cohort study","volume":"110","author":"Flynn","year":"2022","journal-title":"Contraception"},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"Qi, S., and Fu, X. (2023). Establishment of a predictive model for postpartum hemorrhage in twins: A retrospective study. BMC Pregnancy Childbirth, 23.","DOI":"10.1186\/s12884-023-05933-7"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"636.e1","DOI":"10.1016\/j.ajog.2014.11.035","article-title":"Maternal circulating angiogenic factors in twin and singleton pregnancies","volume":"212","author":"McElrath","year":"2015","journal-title":"Am. J. Obstet. Gynecol."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"1281","DOI":"10.1111\/j.1537-2995.2007.01271.x","article-title":"Identification and quantification of fetal red blood cells in maternal blood by a dual -color flow cytometric method: Evaluation of the Fetal Cell Count kit","volume":"47","author":"Porra","year":"2007","journal-title":"Transfusion"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"695","DOI":"10.1002\/cyto.b.21598","article-title":"The presence of F cells with a fetal phenotype in adults with hemoglobinopathies limits the utility of flow cytometry for quantitation of fetomaternal hemorrhage","volume":"94","author":"Otchman","year":"2018","journal-title":"Cytometry"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"857","DOI":"10.1309\/A63X-HG9T-VYG2-X6TX","article-title":"Flow cytometric measurement of hemoglobin F in RBCs diagnostic usefulness in the distinction of Hereditiary Persistence of Fetal Hemoglobin (HPFH) and Hemoglobin S\u2014HPFH from other conditions with elevated levels of hemoglobin F","volume":"117","author":"Hoyer","year":"2002","journal-title":"Am. J. Clin. Pathol."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"821","DOI":"10.1080\/00016340701415509","article-title":"Comparison of two techniques for the evaluation of fetomaternal hemorrhage in RhD\u2014Negative women: Gel agglutination and haemoglobin F determination by flow cytometry","volume":"86","author":"Belkin","year":"2007","journal-title":"Acta Obs. Et Gynecol."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/13\/12\/3609\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T15:01:32Z","timestamp":1760108492000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/13\/12\/3609"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,6,20]]},"references-count":33,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2024,6]]}},"alternative-id":["jcm13123609"],"URL":"https:\/\/doi.org\/10.3390\/jcm13123609","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,6,20]]}}}