PE with chronic fetal-maternal transfusion

[expert@preeclampsia.org]

With my first pregnancy I had what I have been told was a rare event. I had mild preeclampsia (blood pressure no higher than 150/98 and controlled with bed rest) that landed me in the hospital from 34-37 weeks. I was induced a 37 week even. When my son was born they blood work in the NICU showed he was severely anemic (1/2X blood with a reading of 8). They re-ran the test three times because he was doing relatively well and could not believe how anemic he was. When they tested my blood sample from admission (weeks before birth) it was "caulked full of fetal cells" and when they checked his bone marrow was ramped up 5X. It had been a chronic fetal-maternal transfusion. He did fine (some issues with feeding and failure to thrive, a PDA and another benign heart murmur) and is a healthy 2.5 year old. I am 31 weeks with my second and am concerned that if this happens again it may not turn out so well. My son and I are both O (he is neg. I am +) but my husband is A so if I am transfused by type A that could be an issue or another bleed could just be much harder on this child vs. my first. I work in medical research and can not find any literature on this. Did the transfusion cause the preeclampsia or was it the other way around (my hands and face started swelling long before my BP went up)? My son passed all of the non-stress tests and no flags were detected in the hospital. How should I be monitored this time? Is there any literature out there?

[expert@preeclampsia.org]

Based on current understanding if there is any relationship at all a fetal maternal transfusion would be protective as exposure to paternal antigens appears to be protective (reduced risk with second babies, blood tranfusions, and use of non barrier contraception.)