title: Prediction of fetal anemia by different thresholds of MCA-PSV and Delta-OD in first and second intrauterine transfusions.
abstract: BACKGROUND
  Our aim was to compare different thresholds of middle cerebral artery peak systolic velocity (MCA-PSV) and amniotic fluid delta optical density (Delta-OD) with fetal hemoglobin (Hb) during first and second intrauterine transfusions (IUT).
  
  
  METHODS
  We determined serial MCA-PSV and Delta-OD in 27 red blood cell alloimmunized fetuses who needed IUT. Before the second IUT, MCA-PSV was measured. The sensitivity and specificity of MCA-PSV and Delta-OD were calculated and compared with fetal hemoglobin  levels.
  
  
  RESULTS
  From 27 fetuses, first time IUT MCA-PSV with a normal median value (MOM) cutoff of > 1.29 detected 60% of the moderate and 100% of the severe anemia cases. MCA-PSV of MOM > 1.5 detected none of the moderate and 93% of severe anemia cases. Delta-OD detected 50% of moderate anemic and 80% of severe anemic cases. At the second IUT, 91% of severe anemia cases were confirmed by MCA-PSV with MOM > 1.5 whereas MCA-PSV with MOM > 1.29 confirmed all cases. One case of moderate anemia was de-tected by MCA-PSV of MOM > 1.29 and none were detected by MCA-PSV with MOM > 1.5.
  
  
  CONCLUSIONS
  Different thresholds of MCA-PSV have higher sensitivity and specificity for detecting moderate and severe fetal anemia compared with Delta-OD. It also has a high sensitivity at the second IUT.
authors.affiliation: Department of Obstetrics and Gynecology, Women Hospital, Tehran University of Medical Sciences, Tehran, Iran. rahimish@sina.tums.ac.ir
authors.forename: Fatemeh
authors.initials: F
authors.lastname: Rahimi-Sharbaf
authors.forename: Mamak
authors.initials: M
authors.lastname: Shariat
authors.forename: Fatemeh
authors.initials: F
authors.lastname: Mirzaie
authors.forename: Padideh
authors.initials: P
authors.lastname: Dehghan
authors.forename: Ebrahim
authors.initials: E
authors.lastname: Dastgardy
authors.forename: Khadijeh
authors.initials: K
authors.lastname: Adabi
mesh_terms: D000328:Adult; D000649:Amniocentesis; D000653:Amniotic Fluid; D000740:Anemia / Q000175:diagnosis* / Q000628:therapy; D001783:Blood Flow Velocity; D001805:Blood Transfusion, Intrauterine; D005260:Female; D005315:Fetal Diseases / Q000175:diagnosis* / Q000628:therapy; D005319:Fetal Hemoglobin / Q000032:analysis*; D006801:Humans; D020768:Middle Cerebral Artery / Q000000981:diagnostic imaging*; D011247:Pregnancy; D011250:Pregnancy Complications, Hematologic / Q000175:diagnosis / Q000628:therapy; D012203:Rh Isoimmunization / Q000175:diagnosis* / Q000628:therapy; D012680:Sensitivity and Specificity; D013599:Systole; D018608:Ultrasonography, Doppler; D016216:Ultrasonography, Prenatal
chemical_list: D005319:Fetal Hemoglobin