Middle cerebral artery peak systolic velocity in the diagnosis of fetomaternal hemorrhage.

Abstract

OBJECTIVE:

To evaluate whether middle cerebral artery (MCA) peak systolic velocity (PSV) can help to diagnose fetal anemia caused by fetomaternal hemorrhage (FMH).

METHODS:

Fifteen women with FMH were included in a longitudinal prospective study. Participants were evaluated via cardiotocography and Doppler assessment of MCA-PSV. Fetomaternal hemorrhage was confirmed via Kleihauer-Betke test, and fetal hemoglobin levels were determined soon after birth.

RESULTS:

One woman was affected by twin-to-twin transfusion syndrome; FMH was diagnosed with a high MCA-PSV in the recipient fetus, indicating severe anemia. Nine women were referred because of maternal trauma; MCA-PSV values were greater than 1.5 multiples of the median after a mean time of 22.6 hours and cardiotocography showed a sinusoidal pattern in all cases. Mean time of delivery after MCA-PSV assessment was 48.3 hours because of chronic placental abruption. In the other 5 cases, MCA-PSV was normal, cardiotocography showed a sinusoidal pattern, and delivery occurred in a mean time of 3 hours because of acute placental abruption. Kleihauer-Betke testing confirmed FMH, and hemoglobin levels at birth were used to confirm fetal anemia.

CONCLUSION:

Assessment of MCA-PSV may help to detect signs of fetal anemia in cases of chronic FMH.

• Authors: Erich Cosmi, Michela Rampon, Carlo Saccardi, Vincenzo Zanardo, Pietro Litta
• Journal: International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics (Int J Gynaecol Obstet) Vol. 117 Issue 2 Pg. 128-30 (May 2012) ISSN: 1879-3479 [Electronic] United States
• PMID: 22356758 (Publication Type: Journal Article)
• Copyright: Copyright © 2012 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

Chemical References

• Fetal Hemoglobin

Topics

• Abruptio Placentae (epidemiology)
• Anemia (etiology)
• Cardiotocography
• Delivery, Obstetric (methods)
• Female
• Fetal Diseases (diagnosis, etiology)
• Fetal Hemoglobin (metabolism)
• Fetofetal Transfusion (diagnosis)
• Fetomaternal Transfusion (complications, diagnosis)
• Humans
• Infant, Newborn
• Longitudinal Studies
• Middle Cerebral Artery (metabolism)
• Pregnancy
• Prospective Studies
• Time Factors