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Fetal vascular adaptation before and after treatment of severe maternal anemia in pregnancy
Author(s) -
Ali Eram,
Kumar Manisha,
Naqvi Sayyed E.H.,
Trivedi Shubha S.,
Singh Anuradha
Publication year - 2016
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.2015.11.011
Subject(s) - medicine , middle cerebral artery , umbilical artery , anemia , pregnancy , fetus , obstetrics , prospective cohort study , hemoglobin , cohort , vascular resistance , hemodynamics , ischemia , biology , genetics
Objectives To use color Doppler ultrasonography indices to study the effects on fetal circulation of treating severe maternal anemia. Methods A prospective cohort study enrolled patients who were at 30–34 weeks of pregnancy and had hemoglobin levels below 70 g/L between November 1, 2011 and March 31, 2013 at a hospital in New Delhi, India. A control group consisting of patients with the same duration of pregnancy and with hemoglobin levels above 110 g/L was included. Umbilical artery and middle cerebral artery velocimetry were performed using color Doppler ultrasonography at admission and after 4 weeks and 6 weeks of treatment. Results The maternal anemia cohort demonstrated a significantly lower middle cerebral artery resistance index and middle cerebral/umbilical artery resistance ratio ( P < 0.001) at admission. Following 4 weeks of treatment for maternal anemia, significant increases in these parameters were observed ( P < 0.001). Conclusion Fetuses of individuals with severe maternal anemia demonstrated altered cerebral and umbilical artery flows. Normal flows were restored following treatment of maternal anemia.