Document Detail

Middle cerebral artery-peak systolic velocity in dizygotic twins with anti-E alloimmunization.
MedLine Citation:
PMID:  21040209     Owner:  NLM     Status:  MEDLINE    
Middle cerebral artery-peak systolic velocity (MCA-PSV) has been reported to predict fetal anemia with similar accuracy as amniotic ΔOD450 assay. Alloimmunized dizygotic twin pregnancy allows us to compare anemic and non-anemic twins in the same intrauterine environment. We herein present a case of Rh (E)-incompatible dizygotic twin pregnancy, where MCA-PSV could precisely detect the anemia in one of the twins. A 36-year-old woman, whose previous child required exchange transfusion due to hemolytic anemia of newborn (HFDN), conceived twins after in vitro fertilization-embryo transfer. At 24 weeks' gestation, MCA-PSV of twin A and twin B were 23.9 cm/s (0.8 multiples of median; MoM) and 30.7 cm/s (1.0 MoM), respectively. At 31 weeks' gestation, MCA-PSV values of both twins were sharply elevated to nearly 1.4 MoM. Thereafter, MCA-PSV of twin A fell to 1.0 MoM, whereas MCA-PSV of twin B exceeded 1.5 MoM at 34 weeks' gestation. Development of fetal anemia was suspected and emergency cesarean section was performed. Twin B showed moderate anemia with positive direct Coombs' test and was diagnosed as HFDN due to anti-E alloimmunization. Twin B required phototherapy and red cell transfusion, but exchange transfusion was safely obviated.
Yumiko Satake; Yukiyasu Sato; Noriomi Matsumura; Keiji Tatsumi; Hiroshi Fujiwara; Ikuo Konishi
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Publication Detail:
Type:  Case Reports; Journal Article     Date:  2010-10-11
Journal Detail:
Title:  The journal of obstetrics and gynaecology research     Volume:  36     ISSN:  1447-0756     ISO Abbreviation:  J. Obstet. Gynaecol. Res.     Publication Date:  2010 Dec 
Date Detail:
Created Date:  2010-11-30     Completed Date:  2011-03-30     Revised Date:  2012-01-19    
Medline Journal Info:
Nlm Unique ID:  9612761     Medline TA:  J Obstet Gynaecol Res     Country:  Australia    
Other Details:
Languages:  eng     Pagination:  1236-9     Citation Subset:  IM    
Copyright Information:
© 2010 The Authors. Journal of Obstetrics and Gynaecology Research © 2010 Japan Society of Obstetrics and Gynecology.
Department of Gynecology and Obstetrics, Kyoto University Graduate School of Medicine, Kyoto, Japan.
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MeSH Terms
Anemia, Neonatal / immunology,  physiopathology,  ultrasonography*
Blood Flow Velocity
Blood Group Incompatibility / complications*,  physiopathology
Fetal Diseases / etiology,  physiopathology,  ultrasonography*
Infant, Newborn
Middle Cerebral Artery / ultrasonography*
Twins, Dizygotic / physiology*
Ultrasonography, Prenatal

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