Maternal serum alpha-fetoprotein, fetal middle cerebral artery blood flow velocity and fetal haemoglobin in pregnancies at risk of fetal anaemia.
OBJECTIVE
To evaluate the relationships between maternal serum alpha-fetoprotein (MSAFP) levels and both middle cerebral artery (MCA) peak systolic velocity and fetal haemoglobin in women at risk of fetal anaemia.


METHODS
Forty-one measurements of MSAFP were carried out in 22 women at risk of fetal anaemia (16 alloimmunised patients and 6 cases of parvovirus infection) who were monitored by using MCA Doppler measurements. The relationships between MSAFP (MoM) and both MCA peak systolic velocity (z-scores) and fetal haemoglobin (MoM) were studied.


RESULTS
There were significant correlations between MSAFP and both MCA Doppler measurements (r = 0.56, p = 0.00017) and fetal haemoglobin (n = 13, r = -0.71, p = 0.006). MSAFP was higher in cases with fetal anaemia (n = 10) than in those with normal haemoglobin levels (n = 3) (1.7 +/- 0.4 vs 0.8 +/- 0.1 MoM; p = 0.006). In cases of alloimmunised pregnancies with fetal anaemia, MSAFP elevations preceded the presence of increased MCA Doppler velocity by 2.7 weeks (range 0-9 weeks).


CONCLUSIONS
MSAFP is significantly correlated with both MCA Doppler measurements and fetal haemoglobin. Elevations of MSAFP may appear earlier than MCA Doppler abnormalities in cases of fetal anaemia associated with red blood cell alloimmunisation.
Bartha
Jose L
JL
Fetal Medicine Research Unit, Department of Obstetrics and Gynaecology, St Michael's Hospital, University of Bristol, UK. joseluis.bartha@uca.es
Illanes
Sebastian
S
Abdel-Fattah
Sherif A
SA
Harrison
Gayle
G
Soothill
Peter W
PW
D000328:Adult; D000740:Anemia / Q000097:blood / Q000175:diagnosis* / Q000503:physiopathology; D001783:Blood Flow Velocity; D005260:Female; D005315:Fetal Diseases / Q000097:blood / Q000175:diagnosis* / Q000503:physiopathology; D006454:Hemoglobins / Q000032:analysis*; D006801:Humans; D016014:Linear Models; D020768:Middle Cerebral Artery / Q000196:embryology / Q000503:physiopathology*; D011247:Pregnancy; D011296:Prenatal Diagnosis; D011446:Prospective Studies; D000509:alpha-Fetoproteins / Q000032:analysis*
D006454:Hemoglobins; D000509:alpha-Fetoproteins