title: Increasing the noninvasive management of rhesus isoimmunization.
abstract: 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.
authors.affiliation: First Department of Obstetrics and Gynecology, Alexandra Maternity Hospital, Athens University, Athens, Greece.
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Papantoniou
authors.forename: George
authors.initials: G
authors.lastname: Daskalakis
authors.forename: Eleftherios
authors.initials: E
authors.lastname: Anastasakis
authors.forename: Spyros
authors.initials: S
authors.lastname: Marinopoulos
authors.forename: Spyros
authors.initials: S
authors.lastname: Mesogitis
authors.forename: Aris
authors.initials: A
authors.lastname: Antsaklis
mesh_terms: 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
chemical_list: D006454:Hemoglobins