Fetal venous, arterial, and intracardiac blood flows in red blood cell isoimmunization.
OBJECTIVE
To investigate the effect of anemia on fetal venous, arterial, and intracardiac blood flows.


METHODS
Color flow Doppler was used to record flow-velocity waveforms from the atrioventricular valves, ductus venosus, right hepatic vein, inferior vena cava, middle cerebral artery, and descending thoracic aorta from 38 cases of red blood cell isoimmunized pregnancies. Immediately after the Doppler studies, funipuncture was performed and the fetal hemoglobin concentration was measured.


RESULTS
Blood flow velocities in the thoracic aorta, middle cerebral artery, and the ductus venosus were increased compared to reference ranges established previously; however, a significant association with the degree of anemia was found only for the velocity in the thoracic aorta. Pulsatility indices in arteries and veins and the ratio of early to late atrioventricular inflow velocities were not significantly different from normal.


CONCLUSIONS
Fetal anemia is associated with a hyperdynamic circulation in both arterial and venous vessels. Even in severe anemia, there is no evidence of congestive heart failure. Venous and intracardiac Doppler studies do not provide a clinically useful contribution in the management of red blood cell isoimmunization.
Hecher
K
K
Harris Birthright Research Centre for Fetal Medicine, Department of Obstetrics and Gynecology, King's College Hospital Medical School, London, United Kingdom.
Snijders
R
R
Campbell
S
S
Nicolaides
K
K
D000740:Anemia / Q000000981:diagnostic imaging / Q000503:physiopathology*; D001013:Aorta, Thoracic / Q000000981:diagnostic imaging / Q000503:physiopathology*; D001783:Blood Flow Velocity; D002536:Cerebral Arteries / Q000000981:diagnostic imaging / Q000503:physiopathology*; D005260:Female; D005318:Fetal Heart / Q000000981:diagnostic imaging / Q000503:physiopathology*; D006801:Humans; D011247:Pregnancy; D012044:Regression Analysis; D012203:Rh Isoimmunization / Q000000981:diagnostic imaging / Q000503:physiopathology*; D012720:Severity of Illness Index; D018615:Ultrasonography, Doppler, Color; D016216:Ultrasonography, Prenatal; D014680:Veins / Q000000981:diagnostic imaging / Q000503:physiopathology