Perinatal Hemorrhagic Shock After Fetal Scalp Blood Sampling

BACKGROUND: Fetal scalp blood sampling is commonly used for fetal monitoring during labor to identify intrapartum fetal hypoxia. CASE: A male term neonate was monitored by fetal scalp blood sampling because of abnormal cardiotocographic recordings. After emergency cesarean delivery, the newborn presented with severe hemorrhagic shock as a result of fetal anemia from the scalp blood sampling. Two scalp incisions were identified as the bleeding source. The underlying reason for the development of hemorrhagic shock was factor IX-deficiency resulting from spontaneous mutation. The neonate was subsequently discharged a week later without further complications. CONCLUSION: Complications during fetal scalp blood sampling are very rare, but obstetricians and neonatologists should be aware of the potential presence of coagulopathies, especially with the persistence of scalp bleeding after delivery. (Obstet Gynecol 2010;115:419-20)