Fetal Medicine Centre, Birmingham Women's Foundation Trust, Edgbaston, Birmingham, UK.
BJOG. 2009 Nov;116(12):1558-67. doi: 10.1111/j.1471-0528.2009.02255.x. Epub 2009 Aug 13.
To estimate in a systematic review of the literature the diagnostic value of ultrasound and Doppler blood flow velocity in the evaluation of fetal anaemia.
Literature from 2000 to 2008 was identified using MEDLINE and EMBASE, the Cochrane Library and relevant specialist register of the Cochrane Collaboration, and by checking reference lists of known primary studies and review articles. Studies were selected if the accuracy of the fetal ultrasound parameters or Doppler studies of blood flow in the fetal vessels was estimated compared with a reference standard. Data from the selected studies were abstracted as 2 x 2 tables comparing the diagnostic test result with the reference standard. Results were pooled where appropriate. Diagnostic accuracy was expressed as likelihood ratios.
Twenty-five primary studies were identified containing suitable data on middle cerebral artery Doppler peak systolic velocity (MCA-PSV). The largest group of studies whose data could be pooled containing nine studies gave a positive likelihood ratio of 4.30 (95% CI: 2.50 to 7.41) and a negative likelihood ratio of 0.30 (95% CI: 0.13 to 0.69) for 675 cases in detecting severe anaemia in the analysis.
Although middle cerebral artery peak systolic velocity Doppler has limited diagnostic accuracy, it remains the gold standard for noninvasive screening of fetal anaemia.
通过系统评价文献，评估超声和多普勒血流速度在胎儿贫血评估中的诊断价值。
使用 MEDLINE 和 EMBASE、Cochrane 图书馆和 Cochrane 协作组的相关专业登记册，以及通过检查已知原始研究和综述文章的参考文献列表，确定了 2000 年至 2008 年的文献。如果胎儿超声参数或胎儿血管内多普勒血流研究的准确性与参考标准进行了比较，则选择研究。从选定的研究中提取数据作为 2x2 表格，将诊断测试结果与参考标准进行比较。在适当的情况下，对结果进行了汇总。诊断准确性表示为似然比。
确定了 25 项初步研究，其中包含关于大脑中动脉多普勒收缩期峰值速度（MCA-PSV）的合适数据。最大的一组可进行汇总的数据包含 9 项研究，对 675 例病例进行分析，其阳性似然比为 4.30（95%CI：2.50 至 7.41），阴性似然比为 0.30（95%CI：0.13 至 0.69），用于检测严重贫血。
虽然大脑中动脉收缩期峰值速度多普勒具有有限的诊断准确性，但它仍然是胎儿贫血非侵入性筛查的金标准。
