title: Middle cerebral artery peak systolic velocity in fetuses with homozygous alpha-thalassemia-1: case series.
abstract: OBJECTIVE
  The objective of this study is to evaluate the potential usefulness of middle cerebral artery peak systolic velocity (MCA-PSV) as a non-invasive means of detecting an anemic fetus from homozygous alpha-thalassemia-1.
  
  
  METHODS
  We observed four cases of referrals with complicated pregnancies in which the fetuses were suspected with homozygous alpha-thalassemia-1. Three out of four cases involved hydrop fetalis, detected through previous ultrasounds, while the remaining case was referred for prenatal diagnosis. Subsequently, we performed a detailed ultrasound and fetal MCA-PSV in all cases, and to confirm the diagnosis, we also performed cordocentesis.
  
  
  RESULTS
  With all the four cases having the gestational age range from 18 to 27 weeks, three showed hydrop fetalis. The remaining case, the 18-week gestational age fetus referred for prenatal diagnosis, showed an increase in the cardiothoracic ratio without other signs of hydrop fetalis. MCA-PSV suggested the presence of fetal anemia in all cases (with the velocity ranging from 37.3 to 62.2 cm/sec). The results obtained from cordocentesis confirmed fetal anemia and homozygous alpha-thalassemia-1 in all cases.
  
  
  CONCLUSIONS
  Peak systolic velocity of fetal middle cerebral artery can predict anemia in fetus affected with homozygous alpha-thalassemia-1 disease.
authors.affiliation: Department of Obstetrics and Gynecology, HRH Princess Maha Chakri Sirindhorn Medical Center, Faculty of Medicine, Srinakharinwirot University, Nakhon Nayok, Thailand. kasemr@swu.ac.th
authors.forename: Kasem
authors.initials: K
authors.lastname: Raungrongmorakot
authors.forename: Piya
authors.initials: P
authors.lastname: Chaemsaithong
mesh_terms: D001783:Blood Flow Velocity / Q000502:physiology; D002560:Cerebrovascular Circulation; D017218:Cordocentesis; D005260:Female; D005333:Fetus / Q000502:physiology*; D005865:Gestational Age; D006720:Homozygote; D006801:Humans; D020768:Middle Cerebral Artery / Q000000981:diagnostic imaging* / Q000503:physiopathology; D010920:Placenta / Q000000981:diagnostic imaging* / Q000503:physiopathology; D011237:Predictive Value of Tests; D011247:Pregnancy; D013599:Systole; D016216:Ultrasonography, Prenatal / Q000379:methods; D017085:alpha-Thalassemia / Q000000981:diagnostic imaging* / Q000235:genetics / Q000503:physiopathology