title: Middle cerebral artery peak systolic velocity in the diagnosis of fetomaternal hemorrhage.
abstract: OBJECTIVE
  To evaluate whether middle cerebral artery (MCA) peak systolic velocity (PSV) can help to diagnose fetal anemia caused by fetomaternal hemorrhage (FMH).
  
  
  METHODS
  Fifteen women with FMH were included in a longitudinal prospective study. Participants were evaluated via cardiotocography and Doppler assessment of MCA-PSV. Fetomaternal hemorrhage was confirmed via Kleihauer-Betke test, and fetal hemoglobin levels were determined soon after birth.
  
  
  RESULTS
  One woman was affected by twin-to-twin transfusion syndrome; FMH was diagnosed with a high MCA-PSV in the recipient fetus, indicating severe anemia. Nine women were referred because of maternal trauma; MCA-PSV values were greater than 1.5 multiples of the median after a mean time of 22.6 hours and cardiotocography showed a sinusoidal pattern in all cases. Mean time of delivery after MCA-PSV assessment was 48.3 hours because of chronic placental abruption. In the other 5 cases, MCA-PSV was normal, cardiotocography showed a sinusoidal pattern, and delivery occurred in a mean time of 3 hours because of acute placental abruption. Kleihauer-Betke testing confirmed FMH, and hemoglobin levels at birth were used to confirm fetal anemia.
  
  
  CONCLUSIONS
  Assessment of MCA-PSV may help to detect signs of fetal anemia in cases of chronic FMH.
authors.affiliation: Maternal Fetal Medicine Unit, Department of Woman and Child Health, University of Padua School of Medicine, Padua, Italy. ecosmi@hotmail.com
authors.forename: Erich
authors.initials: E
authors.lastname: Cosmi
authors.forename: Michela
authors.initials: M
authors.lastname: Rampon
authors.forename: Carlo
authors.initials: C
authors.lastname: Saccardi
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Zanardo
authors.forename: Pietro
authors.initials: P
authors.lastname: Litta
mesh_terms: D000037:Abruptio Placentae / Q000453:epidemiology; D000740:Anemia / Q000209:etiology; D015148:Cardiotocography; D036861:Delivery, Obstetric / Q000379:methods; D005260:Female; D005315:Fetal Diseases / Q000175:diagnosis* / Q000209:etiology; D005319:Fetal Hemoglobin / Q000378:metabolism; D005330:Fetofetal Transfusion / Q000175:diagnosis; D005331:Fetomaternal Transfusion / Q000150:complications / Q000175:diagnosis*; D006801:Humans; D007231:Infant, Newborn; D008137:Longitudinal Studies; D020768:Middle Cerebral Artery / Q000378:metabolism*; D011247:Pregnancy; D011446:Prospective Studies; D013997:Time Factors
chemical_list: D005319:Fetal Hemoglobin