Middle cerebral artery Doppler velocimetric assessment in two cases of hydrops fetalis without fetal anaemia.
OBJECTIVE
Raised middle cerebral artery (MCA) Doppler velocity has been shown to be highly predictive of moderate to severe fetal anaemia. We present two false-positive cases of raised MCA Doppler velocity in non-immune hydropic fetuses.


METHODS
In both cases, routine investigations for fetal hydrops, as well as detailed ultrasound scanning and MCA peak-systolic velocity Doppler assessment (maximum velocity taken at zero degrees to the vessel), were performed. Fetal blood sampling was carried out at the same visit.


RESULTS
MCA peak-systolic velocity values greater than 1.50 MoM for gestation were found in both cases. However, both fetuses had normal haemoglobin values and haematocrits. Both fetuses died in utero soon after diagnosis.


CONCLUSIONS
A raised MCA velocity in a hydropic fetus may not always be due to fetal anaemia, rather it may indicate a fetus in poor condition perhaps due to cardiovascular decompensation and redistribution of blood to the fetal brain.
Shah
Neil K
NK
Department of Reproductive and Child Health, Birmingham Women's Hospital, Metchley Park Road, Edgbaston, Birmingham, UK.
Martin
William L
WL
Whittle
Martin J
MJ
D000328:Adult; D001783:Blood Flow Velocity; D001921:Brain / Q000098:blood supply*; D003937:Diagnosis, Differential; D005260:Female; D005313:Fetal Death; D006801:Humans; D015160:Hydrops Fetalis / Q000175:diagnosis* / Q000503:physiopathology*; D017078:Laser-Doppler Flowmetry; D020768:Middle Cerebral Artery / Q000502:physiology*; D011247:Pregnancy; D011262:Pregnancy Trimester, Second; D011296:Prenatal Diagnosis; D011673:Pulsatile Flow