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Increasing the noninvasive management of rhesus isoimmunization
Author(s) -
Papantoniou Nikolaos,
Daskalakis George,
Anastasakis Eleftherios,
Marinopoulos Spyros,
Mesogitis Spyros,
Antsaklis Aris
Publication year - 2008
Publication title -
international journal of gynecology and obstetrics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.895
H-Index - 97
eISSN - 1879-3479
pISSN - 0020-7292
DOI - 10.1016/j.ijgo.2007.11.021
Subject(s) - medicine , middle cerebral artery , hematocrit , anemia , gestation , fetus , obstetrics , blood transfusion , confidence interval , pregnancy , surgery , ischemia , biology , genetics
Objective To determine the clinical outcome of isoimmunized pregnancies managed by middle cerebral artery peak systolic velocity (MCA‐PSV) in an intention‐to‐treat study. Method Rhesus isoimmunized pregnancies were managed with serial ultrasound and Doppler studies at 7‐day intervals up to 34 weeks of gestation, between 2001 and 2005. Invasive diagnostic and therapeutic procedures were carried out when MCA‐PSV was indicative of moderate or severe anemia. Results The overall sensitivity in detecting moderate to severe fetal anemia at less than 34 weeks was 100% (95% confidence interval, 54.1–100.0 L). Twenty‐two cases were managed with MCA‐PSV. Twelve cases needed fetal blood sampling and 6 cases needed intrauterine transfusion. Cordocentesis revealed a hematocrit of more than 26% in 6 fetuses. Conclusion Management by MCA‐PSV Doppler at weekly intervals is a highly sensitive method for detecting fetal anemia. It reduces the number of fetal blood samples needed and significantly lowers interventional procedures.