Role of MCA-PSV in managing fetal anemias of non-alloimmunized origin

  • Published 2013

Abstract

The news that a fetus is normal and healthy on obstetric ultrasound scan brings immeasurable joy and satisfaction to the would be parents. However, this serene bounty can get haunted if the fetus develops signs of anemia. Although red blood cell alloimmunization remains one of the major causes of anemia in the fetus, never the less multiple other causes have been reported in non-alloimmunized pregnancies and are the focus of this article. Color Doppler ultrasound shows abnormal rise in peak systolic velocity of the middle cerebral artery (MCA-PSV) in presence of fetal anemia. This article discusses how measurement of middle cerebral artery peak systolic velocity helps in managing and monitoring such fetuses and emphasizes the need to routinely use this criterion along with other fetal biometry markers in all obstetric ultrasound scans for early detection of such mishaps before they become life threatening to the fetus as well as the mother. In right hands; this method is highly effective and economical as it is non invasive and therefore repeatable as per the need, even at bedside. Stress is also laid on the correct method of obtaining the values of fetal MCA-PSV and using the concept of multiples of median for their comparisons at different gestational ages. Key wordsFetal anemia, Middle cerebral artery peak systolic velocity, Doppler Ultrasound Introduction All around the world, routinely not much is spoken about an entity called fetal anemia to the expectant parents. But nobody can deny the importance of early diagnosis and timely management of fetal anemias. The fact that around 10% of newborns, 31% low birth weights and 39% premature births, need blood transfusions when compared to control group strongly points out that anemia is quite common in fetuses and newborns; and that it still remains under reported as it is mostly unsuspected. Therefore improved neonatal outcomes are possible only by early detection and prompt intervention by means of intrauterine transfusion or labor induction for neonatal therapy. Therefore, a diagnostic delay can result in an increased intra and perinatal morbidity and mortality rates. Common causes of fetal anemia in non-alloimmunized pregnancies 1. Homozygous alpha-thalassemia-1 is inherited as an autosomal recessive entity and is the most severe form of alpha-thalassaemias. The affected fetus can develop anemia right from first trimester itself. South-east Asia, the Middle-East Mediterranean basin and Africa are the commonly affected geographical locations. The risk of recurrence is 25 % per pregnancy. Indian Journal of Basic & Applied Medical Research; June 2013: Issue-7, Vol.-2, P. 773-778

Cite this paper

@inproceedings{2013RoleOM, title={Role of MCA-PSV in managing fetal anemias of non-alloimmunized origin}, author={}, year={2013} }