title: Doppler middle cerebral artery peak systolic velocity for diagnosis of neonatal anemia.
abstract: OBJECTIVE
  The peak systolic velocity (PSV) of the middle cerebral artery was found to be predictive of fetal anemia and is routinely applied in the treatment of such fetuses. Our objective was to determine whether a correlation exists between the PSV in the neonatal middle cerebral artery and hemoglobin levels for possible future implementation in clinical practice.
  
  
  METHODS
  A prospective study on 151 neonates was conducted, examining their middle cerebral artery PSV concomitantly with their hemoglobin level during the first 36 hours after delivery. The study population included 122 normocythemic, 24 anemic, and 5 polycythemic neonates. An analysis of variance between normocythemic, anemic, and polycythemic neonates was performed, and a regression analysis of the PSV versus hemoglobin levels was conducted.
  
  
  RESULTS
  The normocythemic neonates had a mean middle cerebral artery PSV ± SD of 41.3 ± 11.4 cm/s, whereas the anemic neonates had a significantly higher PSV (63.8 ± 28.5 cm/s), and the polycythemic neonates had a significantly lower PSV (26.8 ± 7.4 cm/s; P < .001). A statistically significant correlation was found between hemoglobin levels and the middle cerebral artery PSV (P < .01).
  
  
  CONCLUSIONS
  Neonatal anemia and polycythemia can be rapidly diagnosed at the bedside by examining the middle cerebral artery PSV. This technique can be used as an ancillary measure to promptly diagnose acute neonatal blood volume changes for an immediate intervention.
authors.affiliation: Department of Obstetrics and Gynecology, Rambam Health Care Campus, 8 Ha'Aliyah St, 35254 Haifa, Israel. wamir@netvision.net.il
authors.forename: Amir
authors.initials: A
authors.lastname: Weissman
authors.forename: Irena
authors.initials: I
authors.lastname: Olanovski
authors.forename: Zeev
authors.initials: Z
authors.lastname: Weiner
authors.forename: Shraga
authors.initials: S
authors.lastname: Blazer
mesh_terms: D000704:Analysis of Variance; D000751:Anemia, Neonatal / Q000000981:diagnostic imaging*; D001783:Blood Flow Velocity; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D020768:Middle Cerebral Artery / Q000000981:diagnostic imaging*; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012044:Regression Analysis; D014463:Ultrasonography