Anemias of unknown etiology in the fetus and newborn: the symbiosis of obstetric and neonatal care (literature review and clinical case)

Summary. Congenital anemia represents a significant challenge in perinatal diagnostics due to its high prevalence and the risk of severe complications in both the fetus and the neonate. Therefore, the study and advancement of diagnostic and therapeutic approaches for fetal anemia remain a critical priority in modern perinatology.
Objective. To present a modern approach to the diagnosis and treatment of congenital anemia in the fetus and newborn based on an analysis of current literature data and a clinical case.
Materials and Methods. A literature review over the past 10 years was conducted using databases such as Medline, Scopus, Web of Science, Google Scholar, PubMed, Wiley, and the Cochrane Library. A clinical case of discordant dichorionic twins with severe anemia in one of the fetuses was analyzed.
Results. T he m ain c auses o f c ongenital a nemia w ere c onsidered, i ncluding i soimmunization, fetal blood loss, intrauterine infection, genetic and neoplastic diseases. The key role of non-invasive diagnosis of fetal anemia through the measurement of peak systolic velocity in the middle cerebral artery was emphasized. The effectiveness of intrauterine blood transfusion as the primary treatment method for severe anemia was demonstrated. The clinical case illustrated the complexities of differential diagnosis associated with the potential development of anemia-polycythemia syndrome in dichorionic placentation, as well as the impact of intrauterine infection and umbilical cord pathology on anemia formation. Timely prenatal diagnosis, intrauterine transfusions, and subsequent postnatal treatment ensured a favorable perinatal outcome.
Conclusion. The analysis of literature and the clinical case demonstrate the importance of a timely multidisciplinary and individualized approach to the diagnosis and treatment of congenital anemia using modern ultrasound technologies and intrauterine interventions to improve the prognosis for fetuses and newborns.

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