Background: To discuss a series of complex non-immune fetal anemia cases, including etiology, investigations, workup, diagnosis, and management.
Materials and methods: Five complex non-immune cases of fetal anemia seen in our department are presented.
Results: Of the five cases presented, all are live births with follow-up least up to 1.5 years of age. They are cases of hereditary spherocytosis, congenital dyserythropoietic anemia, MCDA twins—twin-twin transfusion syndrome (TTTS) post-laser co-twin demise-fetal anemia, placental chorioangioma, and massive fetomaternal hemorrhage.
Conclusion: Non-immune causes of fetal anemia can be difficult to diagnose its etiology and hence complex to manage. Repeated intrauterine transfusions may be the only perinatal management. The perinatal morbidity/mortality and preterm delivery rates are increased, and some cases require long-term treatment including regular transfusions. We present our experience of a series of complex non-immune fetal anemia managed in a tertiary unit, review the literature, and suggest appropriate management.
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