Department of Obstetrics and Gynecology, Lady Hardinge Medical College, New Delhi, India.
Int J Gynaecol Obstet. 2017 Dec;139(3):307-311. doi: 10.1002/ijgo.12318. Epub 2017 Sep 28.
To construct reference charts for the fetal middle cerebral artery (MCA) peak systolic velocity (PSV,) and the corresponding cord blood hemoglobin values at 24-40 weeks of pregnancy for the identification of fetal anemia.
In a cross-sectional study, 300 women with a pregnancy duration of 24-40 weeks planned for delivery within 72 hours underwent a Doppler study of the MCA and cord blood hemoglobin estimation at delivery. Regression analysis was used to construct reference charts. The validity of the charts was assessed in 40 fetuses from Rhesus-isoimmunized pregnancies.
The MCA PSV and hemoglobin values increased with advancing gestational age. Multiples of the median (MOM) were calculated and reference charts were constructed for mild anemia (MCA PSV 1.29 MOM; hemoglobin 0.8 MOM), moderate anemia (MCA PSV 1.50 MOM; hemoglobin 0.6 MOM), and severe anemia (MCA PSV 1.55 MOM; hemoglobin 0.5 MOM). In the validation sample, the hemoglobin value estimated on the basis of the MCA PSV corresponded with the actual hemoglobin range in 90% of the fetuses. The sensitivity was 92% and the specificity was 95%.
The constructed charts are suitable for the evaluation of fetal anemia in the regional population.
构建胎儿大脑中动脉（MCA）峰值收缩速度（PSV）与 24-40 孕周相应脐血血红蛋白值的参考图表，以识别胎儿贫血。
在一项横断面研究中，300 名妊娠 24-40 周、计划在 72 小时内分娩的妇女在分娩时接受了 MCA 多普勒研究和脐血血红蛋白估测。采用回归分析构建参考图表。在 40 例 Rh 同种免疫妊娠胎儿中评估了图表的有效性。
MCA PSV 和血红蛋白值随胎龄的增加而增加。计算了中位数的倍数（MOM），并为轻度贫血（MCA PSV 1.29 MOM；血红蛋白 0.8 MOM）、中度贫血（MCA PSV 1.50 MOM；血红蛋白 0.6 MOM）和重度贫血（MCA PSV 1.55 MOM；血红蛋白 0.5 MOM）构建了参考图表。在验证样本中，基于 MCA PSV 估计的血红蛋白值与胎儿的实际血红蛋白范围在 90%的情况下相符。敏感性为 92%，特异性为 95%。
所构建的图表适用于评估本地区人群的胎儿贫血。
