Document Detail


Prediction of fetal anemia in pregnancies with red-cell alloimmunization: comparison of middle cerebral artery peak systolic velocity and amniotic fluid OD450.
MedLine Citation:
PMID:  15789409     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To compare the accuracy of Doppler velocimetry (middle cerebral artery peak systolic velocity, MCA-PSV) and amniocentesis (amniotic fluid delta optical density 450 (OD450)) for the detection of fetal anemia against the gold standard of fetal blood sampling (FBS). METHODS: Thirty-eight pregnancies were identified to be at risk of fetal anemia from immune causes between January 2000 and May 2002. In a cross-sectional diagnostic accuracy study, MCA-PSV and amniotic fluid delta OD450 values were plotted on reference charts and compared to an FBS obtained within the subsequent 7 days. Receiver-operating characteristics (ROC) curves were used and the area under the curve (AUC) calculated to compare the overall accuracy of the two tests. Sensitivity, specificity and likelihood ratios for positive (LR+) and negative (LR-) test results were generated for specific thresholds of MCA-PSV and delta OD450. RESULTS: For MCA-PSV (n = 38), the AUC was 0.71 (95% CI 0.57-0.85) and for amniotic fluid delta OD450 (n = 22) it was 0.68 (95% CI 0.49-0.87) compared with FBS within 7 days. Sensitivity, specificity and LR+, LR- for MCA-PSV were 64%, 81%, 3.4 and 0.5, respectively, and 53%, 71%, 1.9 and 0.7 for amniotic fluid OD450, respectively. CONCLUSION: MCA-PSV and OD450 have similar test accuracy in detecting fetal anemia. MCA-PSV is non-invasive and therefore presents no risk of miscarriage or preterm labor and thus is a preferable method of screening for fetal anemia.
Authors:
R Bullock; W L Martin; A Coomarasamy; M D Kilby
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology     Volume:  25     ISSN:  0960-7692     ISO Abbreviation:  Ultrasound Obstet Gynecol     Publication Date:  2005 Apr 
Date Detail:
Created Date:  2005-04-04     Completed Date:  2005-07-12     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  9108340     Medline TA:  Ultrasound Obstet Gynecol     Country:  England    
Other Details:
Languages:  eng     Pagination:  331-4     Citation Subset:  IM    
Copyright Information:
Copyright 2005 ISUOG
Affiliation:
Division of Reproductive and Child Health, Birmingham Women's Hospital, Birmingham, UK.
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MeSH Terms
Descriptor/Qualifier:
Amniocentesis / methods*
Amniotic Fluid / physiology
Blood Flow Velocity / physiology
Cross-Sectional Studies
Erythroblastosis, Fetal / diagnosis*,  ultrasonography
Female
Fetal Blood / physiology
Humans
Middle Cerebral Artery / physiopathology*
Predictive Value of Tests
Pregnancy
ROC Curve
Rh Isoimmunization / complications*,  ultrasonography
Sensitivity and Specificity
Ultrasonography, Doppler / methods
Ultrasonography, Prenatal / methods

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


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