Maternal Fetal Medicine Unit, Department of Woman and Child Health, University of Padua School of Medicine, Padua, Italy.
Int J Gynaecol Obstet. 2012 May;117(2):128-30. doi: 10.1016/j.ijgo.2011.12.016. Epub 2012 Feb 20.
To evaluate whether middle cerebral artery (MCA) peak systolic velocity (PSV) can help to diagnose fetal anemia caused by fetomaternal hemorrhage (FMH).
Fifteen women with FMH were included in a longitudinal prospective study. Participants were evaluated via cardiotocography and Doppler assessment of MCA-PSV. Fetomaternal hemorrhage was confirmed via Kleihauer-Betke test, and fetal hemoglobin levels were determined soon after birth.
One woman was affected by twin-to-twin transfusion syndrome; FMH was diagnosed with a high MCA-PSV in the recipient fetus, indicating severe anemia. Nine women were referred because of maternal trauma; MCA-PSV values were greater than 1.5 multiples of the median after a mean time of 22.6 hours and cardiotocography showed a sinusoidal pattern in all cases. Mean time of delivery after MCA-PSV assessment was 48.3 hours because of chronic placental abruption. In the other 5 cases, MCA-PSV was normal, cardiotocography showed a sinusoidal pattern, and delivery occurred in a mean time of 3 hours because of acute placental abruption. Kleihauer-Betke testing confirmed FMH, and hemoglobin levels at birth were used to confirm fetal anemia.
Assessment of MCA-PSV may help to detect signs of fetal anemia in cases of chronic FMH.
评估大脑中动脉（MCA）收缩期峰值速度（PSV）是否有助于诊断因胎儿-母体出血（FMH）引起的胎儿贫血。
15 名患有 FMH 的妇女参与了一项纵向前瞻性研究。通过胎心监护和 MCA-PSV 的多普勒评估进行评估。通过 Kleihauer-Betke 试验确认 FMH，并在出生后立即确定胎儿血红蛋白水平。
1 名妇女患有双胎输血综合征；受血胎儿的 MCA-PSV 较高，表明严重贫血，FMH 被诊断为严重贫血。9 名妇女因母体创伤而转介；MCA-PSV 值在平均 22.6 小时后大于中位数的 1.5 倍，所有病例的胎心监护均呈正弦波模式。由于慢性胎盘早剥，MCA-PSV 评估后的平均分娩时间为 48.3 小时。在另外 5 例中，MCA-PSV 正常，胎心监护呈正弦波模式，由于急性胎盘早剥，平均分娩时间为 3 小时。Kleihauer-Betke 检测证实了 FMH，出生时的血红蛋白水平用于确认胎儿贫血。
MCA-PSV 的评估可能有助于检测慢性 FMH 病例中胎儿贫血的迹象。
