Document Detail


Prediction of fetal anemia by Doppler of the middle cerebral artery and descending thoracic aorta.
MedLine Citation:
PMID:  18066565     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Despite significant advances, perinatal hemolytic disease has not been eradicated and is still associated with significant morbidity and mortality, especially in developing countries. An accurate method for antenatal diagnosis and quantification of fetal anemia is a crucial step prior to the performance of invasive procedures, which are not risk-free. The middle cerebral artery peak systolic velocity (MCA-PSV) is currently the most popular non-invasive diagnostic method used to quantify fetal anemia and determine the exact timing for transfusion The combined use of MCA-PSV and descending thoracic aorta mean velocity (DTA-MV) has not been previously evaluated. Since this strategy has the potential to decrease false positive results it could reduce unnecessary cordocenteses, therefore minimizing fetal risks. This study aimed to evaluate the accuracy of MCA-PSV associated with DTA-MV in the prediction of fetal anemia. METHOD: Retrospective analysis of 90 cordocenteses performed on alloimmunized pregnancies in a single hospital MCA-PSV and DTA-MV were performed immediately before cordocentesis. The Dopplervelocimetry findings were compared with fetal hemoglobin concentration. Sensitivity, specificity, positive and negative predictive values and accuracy of MCA-PSV and DTA-MV in the prediction of moderate/severe fetal anemia were calculated. RESULTS: The individual sensitivity of MCA-PSV and DTA-MV was 100 and 95.7%, specificity was 65 and 100% and accuracy was 92.2 and 96.7%, respectively. The combination of both vessels produced a higher overall accuracy (98.6%). CONCLUSION: MCA-PSV is more sensitive and DTA-MV is more specific in the detection of fetal anemia. The highest diagnostic accuracy was obtained by the association of both Doppler evaluations.
Authors:
David Pares; Paulo A Chinen; Luiz Camano; Antonio F Moron; Maria R Torloni
Related Documents :
12709925 - Assessment of uterine placental circulation in thrombophilic women.
1695525 - Uterine artery doppler in the investigation of pregnancies with raised maternal serum a...
16076615 - The umbilical coiling index, a review of the literature.
18089595 - Pregnancy enhances the prejunctional vasodilator response to adrenomedullin in selectiv...
5085665 - Microbial metabolism of c 1 and c 2 compounds. the involvement of glycollate in the m...
3062155 - Diagnosis and intrauterine management of enlargement of the cerebral ventricles.
Publication Detail:
Type:  Journal Article     Date:  2007-12-08
Journal Detail:
Title:  Archives of gynecology and obstetrics     Volume:  278     ISSN:  0932-0067     ISO Abbreviation:  Arch. Gynecol. Obstet.     Publication Date:  2008 Jul 
Date Detail:
Created Date:  2008-05-28     Completed Date:  2008-11-05     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8710213     Medline TA:  Arch Gynecol Obstet     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  27-31     Citation Subset:  IM    
Affiliation:
Fetal Medicine Unit, Obstetrics Department, São Paulo Federal University Medical School, São Paulo, Brazil.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Adult
Anemia / blood,  diagnosis*
Aorta, Thoracic / ultrasonography*
Blood Flow Velocity
Female
Fetal Diseases / blood,  diagnosis*
Hemoglobins / analysis
Humans
Middle Cerebral Artery / ultrasonography*
Predictive Value of Tests
Pregnancy
Retrospective Studies
Sensitivity and Specificity
Systole
Ultrasonography, Doppler
Ultrasonography, Prenatal
Chemical
Reg. No./Substance:
0/Hemoglobins

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Endometrioid carcinoma of the endometrium with choriocarcinomatous differentiation: a case report an...
Next Document:  Effects of raloxifene and hormone replacement therapy on serum Th2 and Th3 type cytokine concentrati...