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A new splenic artery Doppler velocimetric index for prediction of severe fetal anemia associated with Rh alloimmunization

1999; Elsevier BV; Volume: 180; Issue: 1 Linguagem: Inglês

10.1016/s0002-9378(99)70148-1

1097-6868

Ray Bahado‐Singh, Utku Öz, Özgür Deren, Jouko Pirhonen, Ertuğ Kovanci, Joshua A. Copel, Lütfü Önderoğlu,

Prenatal Screening and Diagnostics

We developed a new Doppler index for the noninvasive prediction of severe fetal anemia by means of Doppler velocimetry of the main splenic artery.Doppler velocimetry of the main splenic artery was performed in 85 healthy fetuses and in 22 nonhydropic study case patients (41 measurements) at risk for anemia from Rh sensitization. The deceleration angle between the line describing the average slope during the diastolic phase of the cycle and the vertical axis was measured and expressed in multiples of the median (MoM) for gestational age. Severe anemia was defined as a hemoglobin deficit (mean hemoglobin for gestational age minus measured hemoglobin) >/=5 g/dL. Anemia overall was defined as a hemoglobin deficit >/=2 g/dL.Mean gestational age at cordocentesis was 28.6 weeks. Severe anemia was noted on 7 occasions (12.6%) and anemia was noted on 21 (51.2%) occasions. There was a significant correlation between deceleration angle and hemoglobin deficit >/=2 g/dL (r = 0.5763, P <.0001) and also with hemoglobin deficit >/=5 g/dL (r = 0.6418, P <.0001). At deceleration angles <0. 90 MoM, a 90.5% sensitivity and a 30% false-positive rate were achieved for anemia detection. At a threshold deceleration angle of 91% reduction in the rate of cordocentesis.