Abstract
Purpose
Measurement of fetal middle cerebral artery peak systolic velocity (MCA-PSV) is now universally recommended for noninvasive assessment and follow-up of fetal anemia. However, a literature review suggests that the fetal MCA-PSV range is different for Asian and non-Asian populations. A study was therefore undertaken to compare and contrast MCA-PSV values in the local obstetrical population with those of previously published studies done elsewhere.
Materials and methods
Fetal MCA-PSV was measured in normal 100 pregnant women attending the outpatient antenatal clinic using Doppler ultrasonography, which was performed at least once between 12 and 40 weeks of gestation.
Results
A positive statistically significant (P < 0.05) correlation was seen between gestational age and MCA-PSV. The 5th (17.0 vs. 24.9 cm/s), 50th (23.0 vs. 32.4 cm/s), and 95th (38.0 vs. 41.1 cm/s) percentile values of MCA-PSV at 25 weeks of gestation in the present study were consistently lower than those cited in other studies.
Conclusion
The results indicate that a local fetus would be anemic even before its MCA-PSV rises to the internationally accepted standard of fetal anemia. Hence, by the time the MCA-PSV value of the local fetus rises to the point where it is deemed severely anemic as per values mentioned in other published literature, it might be too late for intervention and the fetal health as well as life might be at stake. Each geographic locality should therefore develop its own standard values.
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References
Nardozza LM, Araujo EJ, Simioni C, Camano L, Moron AF. Nomogram of fetal middle cerebral artery peak systolic velocity in a Brazilian population. Radiol Bras 2008;41(6). doi: 10.1590/S0100-39842008000600008 (abstract).
Kurmanavicius J, Streicher A, Wright EM, Wisser J, Muller R, Royston P, et al. Reference values of fetal peak systolic blood velocity in the middle cerebral artery at 19–40 weeks of gestation. Ultrasound Obstet Gynecol 2001;17:50–53.
Mari G, Deter RL, Carpenter RL, Rahman F, Zimmerman R, Moise KJ, et al. Noninvasive diagnosis by Doppler ultrasonography of fetal anemia due to maternal red-cell alloimmunization: Collaborative Group for Doppler Assessment of the Blood Velocity in Anemic Fetuses. N Engl J Med 2000;342:9–14.
Hernandez-Andrade E, Scheier M, Dezerega V, Carmo A, Nicolaides KH. Fetal middle cerebral artery peak systolic velocity in the investigation of non-immune hydrops. Ultrasound Obstet Gynecol 2004;23:442.
Tan KB, Fook-Chong SM, Lee SL, Tan LK. Foetal peak systolic velocity in the middle cerebral artery: an Asian reference range. Singapore Med J 2009;50:584–586.
Nardozza LM, Camano L, Moron AF, Pares DB, Shinen RA, Torloni MR. Pregnancy outcome for Rh-alloimmunized women. Int J Gynaecol Obstet 2005;90:103–106.
Bowman JM, Pollock JM. Transplacental fetal hemorrhage after amniocentesis. Obstet Gynecol 1985;66:749–754.
MacGregor SN, Silver RK, Sholl JS. Enhanced sensitization after cordocentesis in a rhesus-isoimmunized pregnancy. Am J Obstet Gynecol 1991;165:382–383.
Dukler D, Oepkes D, Seaward G, Windrim R, Ryan G. Noninvasive tests to predict fetal anemia: a study comparing Doppler and ultrasound parameters. Am J Obstet Gynecol 2003;188:1310–1314.
Hobbins JC. Use of ultrasound in complicated pregnancies. Clin Perinatol 1980;7:397–411.
Oepkes D, Meerman RH, Vandenbussche FP, Van Kamp IL, Kok FG, Kanhai HH. Ultrasonographic fetal spleen measurements in red blood cell-alloimmunized pregnancies. Am J Obstet Gynecol 1993;169:121–128.
Arduini D, Rizzo G. Prediction of fetal outcome in small for gestational age fetuses: comparison of Doppler measurements obtained from different fetal vessels. J Perinat Med 1992;20:29–38.
Fan FC, Chen RYZ, Schuessler GB, Chien S. Effects of hematocrit variations on regional hemodynamics and oxygen transport in the dog. Am J Physiol 1980;238:H545–H552.
Stefos T, Cosmi E, Detti L, Mari G. Correction of fetal anemia on the MCA-PSV. Obstet Gynecol 2002;99:211–215.
Mari G, Abuhamad AZ, Cosmi E, Segata M, Altaye M, Akiyama M. Middle cerebral artery peak systolic velocity: technique and variability. J Ultrasound Med 2005;24:425–430.
Scheier M, Hernandez-Andrade E, Carmo A, Dezerega V, Nicolaides KH. Prediction of fetal anemia in rhesus disease by measurement of fetal middle cerebral artery peak systolic velocity. Ultrasound Obstet Gynecol 2004;23:432–436.
Tongsong T, Wanapirak C, Sirichotiyakul S, Tongprasert F, Srisupundit K. Middle cerebral artery peak systolic velocity of healthy fetuses in the fi rst half of pregnancy. J Ultrasound Med 2007;26:1013–1017.
Deka D, Sharma N, Dadhwal V, Suneeta M. Successful application of middle cerebral artery peak systolic velocity to time intrauterine tranfusions in Rh isoimmunised fetus. J Obstet Gynecol India 2006;56:534–536.
Arora D, Bhattacharyya TK, Kathpalia SK, Kochar SP, Sandhu GS, Goyal BK. Management of Rh-isoimmunised pregnancies: our experience. MJAFI 2007;63:7–11.
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Kachewar, S.G., Gandage, S.G. & Kulkarni, D.S. Fetal middle cerebral artery peak systolic velocities in a local Indian scenario. Jpn J Radiol 29, 725–729 (2011). https://doi.org/10.1007/s11604-011-0625-3
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DOI: https://doi.org/10.1007/s11604-011-0625-3