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Summary. The perinatal outcome associated with fetomaternal macrotransfusion (FMMT), defined as fetomaternal haemorrhage ≥10 ml, was investigated in a study group of 179 cases of FMMT and compared with the outcome in 322 controls selected from the same population. Perinatal mortality and morbidity occurred more frequently in the case group (P<0.01). The mean Apgar score at 1 min and the cord haemoglobin level differed significantly between the case and control groups (P<0.01) and showed a significant inverse correlation with the estimated volumes of FMMT (P<0.0001). There was no significant difference in birth weight between the case and control groups. The mean estimated volumes of FMMT associated with perinatal mortality and with low cord haemoglobin (≤9.0 g/dl) were significantly higher than the mean volume in the case group as a whole, which suggests the possibility of adapting these observations to a screening procedure.