Ultrasonographic fetal spleen measurements in red blood cell-alloimmunized pregnancies.
OBJECTIVE
This study was performed to evaluate the possible relationship between fetal spleen size and fetal hemoglobin levels and to assess the predictive value of ultrasonographically measured fetal spleen size as an estimate of the severity of fetal hemolytic anemia.


METHODS
Before 85 consecutive fetal blood samples in 28 red blood cell-alloimmunized pregnancies ultrasonographic fetal spleen measurements were performed. Results were compared with our own longitudinally derived reference ranges and were correlated with fetal hemoglobin deficit.


RESULTS
A significant positive correlation was found between spleen perimeter and fetal hemoglobin deficit. The ultrasonographic finding of splenomegaly correctly predicted severe fetal anemia (hemoglobin deficit > 5 SD from normal mean) in 44 of 47 cases, a positive predictive value of 94%. At first transfusion all fetuses showing splenomegaly were severely anemic.


CONCLUSIONS
Fetal spleen measurements may be a useful adjunct to ultrasonographic evaluation in the management of severe red blood cell-alloimmunized pregnancies.
Oepkes
D
D
Department of Obstetrics, University Hospital Leiden, The Netherlands.
Meerman
R H
RH
Vandenbussche
F P
FP
van Kamp
I L
IL
Kok
F G
FG
Kanhai
H H
HH
D000740:Anemia / Q000000981:diagnostic imaging / Q000209:etiology; D001787:Blood Group Incompatibility / Q000150:complications / Q000000981:diagnostic imaging*; D004912:Erythrocytes / Q000276:immunology; D005260:Female; D005315:Fetal Diseases / Q000000981:diagnostic imaging / Q000209:etiology; D006454:Hemoglobins / Q000378:metabolism; D006801:Humans; D015160:Hydrops Fetalis / Q000000981:diagnostic imaging; D007519:Isoantigens / Q000276:immunology; D011247:Pregnancy; D011248:Pregnancy Complications / Q000000981:diagnostic imaging*; D013154:Spleen / Q000000981:diagnostic imaging* / Q000196:embryology*; D016216:Ultrasonography, Prenatal
D006454:Hemoglobins; D007519:Isoantigens