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Fetal Diagn Ther. 2017;42(3):225-231. doi: 10.1159/000456661. Epub 2017 Mar 10.

Accuracy of Middle Cerebral Artery Doppler Assessment between 34 and 37 Weeks in Fetuses with Red Cell Alloimmunization.

Author information

1
Department of Fetal Medicine, Hôpital Trousseau, Paris, France.

Abstract

BACKGROUND:

The Doppler measurement of middle cerebral artery peak systolic velocity (MCA-PSV) is considered the gold standard for the noninvasive detection of moderate to severe anemia. However, the accuracy of this test has not been evaluated so far, specifically beyond 34 weeks.

OBJECTIVES:

To assess the accuracy of MCA-PSV to detect moderate to severe fetal anemia and to identify risk factors associated with false-positive and false-negative MCA-PSV values after 34 weeks.

STUDY DESIGN:

We studied a retrospective cohort of 150 pregnant women with severe alloimmunization who delivered between 2010 and 2014 and correlated MCA-PSV and fetal or neonatal hemoglobin levels.

RESULTS:

Sensitivity to predict severe anemia was 69%, with a false-negative rate of 3.6%. When MCA Doppler assessment was normal, the identification of serosal effusions increased the detection rate of severe fetal anemia to 94%, with a false-negative rate of 0.8%. False-positive MCA-PSV measurements were more frequent in fetuses with 1 previous intrauterine transfusion (p = 0.0002), but were not associated with MCA resistance index, intrauterine growth restriction and fetal heart rate.

CONCLUSIONS:

Between 34 and 37 weeks, sensitivity of MCA-PSV Doppler assessment alone is 69% and increases to 94% when also considering signs of hydrops. False-positive MCA-PSV measurements are more frequent in case of former fetal transfusion.

KEYWORDS:

Alloimmunization; Anemia; Doppler ultrasound; Doppler velocimetry; Fetal transfusion; Intrauterine transfusion; Middle cerebral artery Doppler assessment

PMID:
28278506
DOI:
10.1159/000456661
[Indexed for MEDLINE]

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