Noninvasive tests to predict fetal anemia: A study comparing Doppler and ultrasound parameters

Doron Dukler, Dick Oepkes, Gareth Seaward, Rory Windrim, Greg Ryan

Research output: Contribution to journalArticlepeer-review

76 Scopus citations

Abstract

OBJECTIVE: This study was undertaken to compare test characteristics of ultrasound and Doppler parameters in the prediction of fetal anemia in alloimmunized pregnancies. STUDY DESIGN: In a prospective cohort study, 16 nonhydropic fetuses with red blood cell alloimmunization were evaluated with ultrasound and Doppler imaging. Middle cerebral artery (MCA) peak systolic velocity, intrahepatic umbilical venous (IHUV) maximum velocity, liver length, and spleen perimeter were measured. Results before first fetal blood sampling (FBS) or delivery were analyzed. Fetal anemia was defined as hemoglobin deficit 5 SD or greater. Sensitivity and specificity were calculated. RESULTS: Six fetuses were anemic and required intrauterine transfusion, and 10 were not severely anemic at birth. MCA Doppler imaging was the best predictor of fetal anemia (100%), followed by IHUV (83%). Sensitivity was low for spleen perimeter (66%) and liver length (33%). CONCLUSION: Doppler evaluation of MCA peak systolic velocity is better than IHUV maximum velocity, liver, or spleen size in the prediction of fetal anemia in red blood cell alloimmunization.

Original languageEnglish
Pages (from-to)1310-1314
Number of pages5
JournalAmerican Journal of Obstetrics and Gynecology
Volume188
Issue number5
DOIs
StatePublished - 1 May 2003
Externally publishedYes

Keywords

  • Alloimmunization
  • Anemia
  • Doppler
  • Fetus
  • Ultrasound

ASJC Scopus subject areas

  • Obstetrics and Gynecology

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