Massive pulmonary haemorrhage: A cause of sudden unexpected deaths in severely growth retarded infants

To determine aetiological factors a seven year review of massive pulmonary haemorrhage (MPH) was performed at the Mercy Maternity Hospital, Melbourne and compared with 26,208 consecutive live births. Statistically significant correlations were found between MPH and prematurity, birth asphyxia, hyaline membrane disease, breech delivery, multiple births, fetal growth retardation, Caesarean delivery, and the presence of a patent ductus arteriosus. MPH was associated with a mortality of 92.6%. Three severely growth retarded infants with unexpected MPH are presented. These cases indicate that severe intrauterine hypoxia is a major factor predisposing to MPH. Clinicians should be alert for the possibility of MPH in severely growth retarded infants and with vigilance and anticipation a more favourable outcome may be possible