title: Doppler assessment of the fetal cerebral hemodynamic response to moderate or severe maternal anemia.
abstract: OBJECTIVE
  The purpose of this study was to evaluate the fetal vascular adaptation to moderate and severe maternal anemia.
  
  
  METHODS
  Biometry; amniotic fluid index; uterine, cerebral, and umbilical Doppler; and maternal hemoglobin level were measured at admission and 8 days after treatment.
  
  
  RESULTS
  Group 1 consisted of 16 pregnancies (maternal hemoglobin level, 6.9 +/- 0.6 g/100 mL); group 2 consisted of 23 pregnancies (maternal hemoglobin level, 5 +/- 0.6 g/100 mL). At admission the cerebral and cerebral/umbilical Doppler indexes, amniotic index, and biometry were lower in group 2. The uterine index was normal in both groups. An abnormal fetal heart rate was found in group 2 only (48%). At day 8, maternal hemoglobin level and amniotic index increased more in group 2 than in group 1. The cerebral index and the cerebral-to-umbilical resistance ratio increased only in group 2. The abnormal fetal heart rate disappeared in group 2.
  
  
  CONCLUSIONS
  Only severe maternal anemia (maternal hemoglobin level, <6 mg/L) triggered fetal cerebral vasodilation and reduced amniotic volume.
authors.affiliation: Department of Obstetrics and Gynecology, Hopital Andre-Bouron, St Laurent du Maroni, France.
authors.forename: Gabriel
authors.initials: G
authors.lastname: Carles
authors.forename: Nathalie
authors.initials: N
authors.lastname: Tobal
authors.forename: Pierre
authors.initials: P
authors.lastname: Raynal
authors.forename: Stéphane
authors.initials: S
authors.lastname: Herault
authors.forename: Gael
authors.initials: G
authors.lastname: Beucher
authors.forename: Henri
authors.initials: H
authors.lastname: Marret
authors.forename: Philippe
authors.initials: P
authors.lastname: Arbeille
mesh_terms: D000328:Adult; D000653:Amniotic Fluid / Q000378:metabolism; D000740:Anemia / Q000503:physiopathology*; D001808:Blood Vessels / Q000000981:diagnostic imaging; D002560:Cerebrovascular Circulation; D005260:Female; D005333:Fetus / Q000502:physiology*; D006340:Heart Rate, Fetal; D006439:Hemodynamics; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D011247:Pregnancy / Q000097:blood; D011248:Pregnancy Complications / Q000503:physiopathology*; D016216:Ultrasonography, Prenatal; D014470:Umbilical Cord / Q000098:blood supply; D014664:Vasodilation
chemical_list: D006454:Hemoglobins