title: Fetal vascular adaptation before and after treatment of severe maternal anemia in pregnancy.
abstract: OBJECTIVE
  To use color Doppler ultrasonography indices to study the effects on fetal circulation of treating severe maternal anemia.
  
  
  METHODS
  A prospective cohort study enrolled patients who were at 30-34weeks of pregnancy and had hemoglobin levels below 70g/L between November 1, 2011 and March 31, 2013 at a hospital in New Delhi, India. A control group consisting of patients with the same duration of pregnancy and with hemoglobin levels above 110g/L was included. Umbilical artery and middle cerebral artery velocimetry were performed using color Doppler ultrasonography at admission and after 4weeks and 6weeks of treatment.
  
  
  RESULTS
  The maternal anemia cohort demonstrated a significantly lower middle cerebral artery resistance index and middle cerebral/umbilical artery resistance ratio (P<0.001) at admission. Following 4weeks of treatment for maternal anemia, significant increases in these parameters were observed (P<0.001).
  
  
  CONCLUSIONS
  Fetuses of individuals with severe maternal anemia demonstrated altered cerebral and umbilical artery flows. Normal flows were restored following treatment of maternal anemia.
authors.affiliation: Department of Obstetrics and Gynecology, Aligarh Muslim University, Uttar Pradesh, India. Electronic address: eramali1987@gmail.com.
authors.forename: Eram
authors.initials: E
authors.lastname: Ali
authors.affiliation: Department of Obstetrics and Gynecology, Lady Hardinge Medical College, Delhi University, New Delhi, India.
authors.forename: Manisha
authors.initials: M
authors.lastname: Kumar
authors.affiliation: Department of Cardiothoracic and Vascular Surgeons, JN Medical College, Aligarh Muslim University, Aligarh, India.
authors.forename: Sayyed E H
authors.initials: SE
authors.lastname: Naqvi
authors.affiliation: Department of Obstetrics and Gynecology, Lady Hardinge Medical College, Delhi University, New Delhi, India.
authors.forename: Shubha S
authors.initials: SS
authors.lastname: Trivedi
authors.affiliation: Department of Obstetrics and Gynecology, Lady Hardinge Medical College, Delhi University, New Delhi, India.
authors.forename: Anuradha
authors.initials: A
authors.lastname: Singh
mesh_terms: D000740:Anemia / Q000453:epidemiology / Q000628:therapy*; D001783:Blood Flow Velocity; D016022:Case-Control Studies; D005260:Female; D005333:Fetus / Q000098:blood supply* / Q000000981:diagnostic imaging; D005865:Gestational Age; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D007194:India; D020768:Middle Cerebral Artery / Q000000981:diagnostic imaging*; D010298:Parity; D011247:Pregnancy; D011250:Pregnancy Complications, Hematologic / Q000453:epidemiology / Q000628:therapy*; D011446:Prospective Studies; D012720:Severity of Illness Index; D018615:Ultrasonography, Doppler, Color; D014469:Umbilical Arteries / Q000000981:diagnostic imaging*
chemical_list: D006454:Hemoglobins
keywords: Cerebral/umbilical resistance ratio; Doppler velocimetry; Maternal anemia; Middle cerebral artery; Peak systolic velocity; Pulsatility index; Resistance index; Systolic/diastolic ratio; Umbilical artery