Increasing the noninvasive management of rhesus isoimmunization.
OBJECTIVE
To determine the clinical outcome of isoimmunized pregnancies managed by middle cerebral artery peak systolic velocity (MCA-PSV) in an intention-to-treat study.


METHODS
Rhesus isoimmunized pregnancies were managed with serial ultrasound and Doppler studies at 7-day intervals up to 34 weeks of gestation, between 2001 and 2005. Invasive diagnostic and therapeutic procedures were carried out when MCA-PSV was indicative of moderate or severe anemia.


RESULTS
The overall sensitivity in detecting moderate to severe fetal anemia at less than 34 weeks was 100% (95% confidence interval, 54.1-100.0 L). Twenty-two cases were managed with MCA-PSV. Twelve cases needed fetal blood sampling and 6 cases needed intrauterine transfusion. Cordocentesis revealed a hematocrit of more than 26% in 6 fetuses.


CONCLUSIONS
Management by MCA-PSV Doppler at weekly intervals is a highly sensitive method for detecting fetal anemia. It reduces the number of fetal blood samples needed and significantly lowers interventional procedures.
Papantoniou
Nikolaos
N
First Department of Obstetrics and Gynecology, Alexandra Maternity Hospital, Athens University, Athens, Greece.
Daskalakis
George
G
Anastasakis
Eleftherios
E
Marinopoulos
Spyros
S
Mesogitis
Spyros
S
Antsaklis
Aris
A
D000740:Anemia / Q000000981:diagnostic imaging* / Q000209:etiology; D001783:Blood Flow Velocity; D017218:Cordocentesis; D005260:Female; D005312:Fetal Blood / Q000737:chemistry; D005315:Fetal Diseases / Q000000981:diagnostic imaging*; D005865:Gestational Age; D006115:Greece; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D020768:Middle Cerebral Artery / Q000000981:diagnostic imaging*; D011247:Pregnancy; D011250:Pregnancy Complications, Hematologic; D011256:Pregnancy Outcome; D012203:Rh Isoimmunization / Q000150:complications* / Q000000981:diagnostic imaging / Q000628:therapy; D018615:Ultrasonography, Doppler, Color; D016216:Ultrasonography, Prenatal
D006454:Hemoglobins