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Correction of Fetal Anemia on the Middle Cerebral Artery Peak Systolic Velocity

From the Prenatal Diagnosis and Fetal Therapy Center, Department of Obstetrics and Gynecology, University of Virginia, Charlottesville, Virginia.

Address reprint requests to: Giancarlo Mari, MD, Department of Obstetrics and Gynecology, University of Virginia Health Science Center, P.O. Box 800712, Charlottesville, VA 22908. E-mail: gm6p{at}virginia.edu.

OBJECTIVE: To assess the effect of correction of fetal anemia on the middle cerebral artery peak systolic velocity values.

METHODS: With Doppler ultrasonography, middle cerebral artery peak systolic velocity was measured in 41 fetuses before and immediately after 54 intrauterine transfusions for severe red blood cell alloimmunization. The fetuses were divided into two groups: 17 fetuses studied at first transfusion (group A), and 24 fetuses enrolled to the study after the first transfusion (group B). Both fetal hemoglobin and middle cerebral artery peak systolic velocity were plotted over the respective reference ranges as a function of gestational age. Both values were expressed as multiples of the median and analyzed with paired t test.

RESULTS: The values of middle cerebral artery peak systolic velocity decreased in all but one fetus of group B (P < .05). The values of middle cerebral artery peak systolic velocity before transfusion were above the upper limit of the reference range in 60% of the fetuses of group A and in 38% of group B, respectively. After correction of anemia, only one value remained above the upper limit of the reference range.

CONCLUSION: The correction of fetal anemia with intrauterine blood transfusion decreases significantly and normalizes the value of the fetal middle cerebral artery peak systolic velocity.

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