Diagnosis of fetal anemia with Doppler ultrasound in the pregnancy complicated by maternal blood group immunization

TLDR

The study examined whether fetal middle cerebral artery peak systolic velocity measured by Doppler could detect anemia in pregnancies with maternal blood group immunization. The authors established normal velocity ranges in 135 fetuses, correlated 56 cordocenteses in 23 at‑risk fetuses with hematocrit, derived a diagnostic test from these data, and then prospectively applied it to 16 at‑risk fetuses undergoing 42 cordocenteses. An exponential increase in middle cerebral artery peak systolic velocity with gestation was observed, four anemia‑risk zones were defined, and in the prospective cohort all anemic fetuses had velocities above the normal mean, confirming the method as a non‑invasive marker of anemia. © 1995 International Society of Ultrasound in Obstetrics and Gynecology.

Abstract

Abstract We investigated whether Doppler measurement of the fetal middle cerebral artery peak systolic velocity can be used to detect fetal anemia in pregnancies complicated by maternal blood group immunization. We first studied normal values for the middle cerebral artery peak systolic velocity in 135 fetuses (Group A), and also in 23 fetuses at risk for anemia who underwent 56 cordocenteses to assess the fetal hematocrit (Group B). A test to detect fetal anemia, based on the middle cerebral artery peak systolic velocity, was developed by using the data of the fetuses of Group A and Group B. Successively, the middle cerebral artery peak systolic velocity was prospectively determined in 16 fetuses at risk for anemia who underwent 42 cordocenteses (Group C) to assess the test developed, in a multicenter prospective fashion, by using the data of Group A and Group B. In the normal fetuses an exponential model expressed the increase of the middle cerebral artery peak systolic velocity values with advancing gestation. By using the data of the fetuses of Group A and Group B, four zones of anemia risk were identified. In Group C, none of the anemic fetuses had the middle cerebral artery peak velocity below the normal mean value, whereas all of the anemic fetuses had the peak velocity above the normal mean. The middle cerebral artery blood velocity increases with advancing gestation and is a non‐invasive method of detecting anemia in pregnancies complicated by maternal blood group immunization. Copyright © 1995 International Society of Ultrasound in Obstetrics and Gynecology