Raungrongmorakot Kasem, Chaemsaithong Piya
Department of Obstetrics and Gynecology, HRH Princess Maha Chakri Sirindhorn Medical Center, Faculty of Medicine, Srinakharinwirot University, Nakhon Nayok, Thailand.
J Med Assoc Thai. 2010 Feb;93 Suppl 2:S114-7.
The objective of this study is to evaluate the potential usefulness of middle cerebral artery peak systolic velocity (MCA-PSV) as a non-invasive means of detecting an anemic fetus from homozygous alpha-thalassemia-1.
We observed four cases of referrals with complicated pregnancies in which the fetuses were suspected with homozygous alpha-thalassemia-1. Three out of four cases involved hydrop fetalis, detected through previous ultrasounds, while the remaining case was referred for prenatal diagnosis. Subsequently, we performed a detailed ultrasound and fetal MCA-PSV in all cases, and to confirm the diagnosis, we also performed cordocentesis.
With all the four cases having the gestational age range from 18 to 27 weeks, three showed hydrop fetalis. The remaining case, the 18-week gestational age fetus referred for prenatal diagnosis, showed an increase in the cardiothoracic ratio without other signs of hydrop fetalis. MCA-PSV suggested the presence of fetal anemia in all cases (with the velocity ranging from 37.3 to 62.2 cm/sec). The results obtained from cordocentesis confirmed fetal anemia and homozygous alpha-thalassemia-1 in all cases.
Peak systolic velocity of fetal middle cerebral artery can predict anemia in fetus affected with homozygous alpha-thalassemia-1 disease.
本研究的目的是评估大脑中动脉收缩期峰值流速（MCA-PSV）作为一种无创检测纯合子α地中海贫血-1胎儿贫血的潜在有用性。
我们观察了4例转诊的复杂妊娠病例，其中胎儿疑似患有纯合子α地中海贫血-1。4例中有3例涉及胎儿水肿，通过先前的超声检查发现，其余1例转诊进行产前诊断。随后，我们对所有病例进行了详细的超声检查和胎儿MCA-PSV检测，为确诊，我们还进行了脐带穿刺术。
4例病例的孕周范围为18至27周，其中3例显示胎儿水肿。其余1例，即转诊进行产前诊断的18周龄胎儿，显示心胸比增加，但无其他胎儿水肿迹象。MCA-PSV提示所有病例均存在胎儿贫血（流速范围为37.3至62.2厘米/秒）。脐带穿刺术的结果证实所有病例均存在胎儿贫血和纯合子α地中海贫血-1。
胎儿大脑中动脉收缩期峰值流速可预测患有纯合子α地中海贫血-1疾病的胎儿贫血情况。
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