Noninvasive diagnosis by doppler ultrasonography of fetal anemia due to parvovirus infection

Amaç

To evaluate the feasibility of the middle cerebral artery peak systolic velocity in the detection of fetal anemia in pregnancies complicated by parvovirus B 19 infection.

Yöntem

Doppler measurements of the middle cerebral artery peak systolic velocity were weekly performed in 32 fetuses at risk for anemia because of maternal parvovirus infection documented by the presence of IgM. The values of middle cerebral artery peak systolic velocity and hemoglobin were expressed as multiples of the median. Middle cerebral artery values were scattered on reference ranges previously established. A cordocentesis was performed either in presence of fetal ascites or when the middle cerebral artery peak systolic velocity values suggested moderate/severe anemia (middle cerebral artery peak systolic velocity > 1.50 multiples of the median).

Bulgular

Gestational age at study entry ranged from 15.1 to 37 weeks. İn ,sixteen patients the middle cerebral artery peak systolic velocity was below 1.5.0 MoM and there was no sign of hydrops (Group 1). The fetuses of this group did not have any complications and did well at birth. Group 2 included thirteen fetuses that showed both, an elevated value of middle cerebral artery peak systolic velocity and ascites, and three fetuses who had an elevated value of middle cerebral artery peak systolic velocity. İn Group 2, one fetus was mildly anemic. and 15 were severly anemic. The sensitivity of peak systolic velocity for the predietion of anemia because ot parvovirus infection was 94.1 %; with a talse negative rate of 5.8 %. There were no false positive cases and the positive and negative predietive values were 100% and 93.7%, respectively.

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