The middle cerebral artery peak systolic velocity (MCA- PSV) has been successfully used for timing the first 2 transfusions in fetuses at risk for anemia because of maternal red cell alloimmunization. The Abstract of ...The middle cerebral artery peak systolic velocity (MCA- PSV) has been successfully used for timing the first 2 transfusions in fetuses at risk for anemia because of maternal red cell alloimmunization. The Abstract of this study was to assess whether the correlation between the MCA- PSV and fetal hemoglobin is maintained in fetuses that had undergone 2 previous intrauterine transfusions. Study design: Doppler measurement of MCA- PSV was performed before cordocentesis in 39 fetuses. The timing of the third transfusion was based on traditional criteria. The values of MCA- PSV and hemoglobin were expressed as multiples of the median (MoM). Anemia was defined as mild (hemoglobin < 0.84 MoM for a given gestational age, moderate (hemoglobin < 0.65 MoM), and severe (hemoglobin < 0.55 MoM). Regression analysis was used to assess the correlation between the MCA- PSV MoM and fetal hemoglobin MoM. Results: Gestational age at Doppler study ranged from 22 to 35 weeks. Six fetuses (15% ) had normal hemoglobin concentration; 21 (53% ) had mild anemia; 7 (20% ) had moderate anemia; and 5 (12% ) had severe anemia. There was a linear correlation between fetal hemoglobin (y) and the MCA- PSV (x): y = 1.185 - 0.341x. Conclusion: Previously, concerns have been expressed about the accuracy of Doppler prediction of anemia after previous transfusions. Our data suggest that there is a good correlation between the MCA- PSV and fetal hemoglobin in fetuses that have undergone 2 previous transfusions. Our findings expand the clinical situation in which Doppler can be used to monitor red cell alloimmunized pregnancies.展开更多
目的探讨超声检查在胎儿大脑中动脉及脐动脉血流在胎儿宫内缺氧及分娩结局诊断中的应用价值。方法选取2020年8月—2022年2月广东省中山市东凤人民医院收治的孕妇60例,根据是否出现宫内缺氧分为缺氧组(31例)与正常组(29例),再根据围产儿...目的探讨超声检查在胎儿大脑中动脉及脐动脉血流在胎儿宫内缺氧及分娩结局诊断中的应用价值。方法选取2020年8月—2022年2月广东省中山市东凤人民医院收治的孕妇60例,根据是否出现宫内缺氧分为缺氧组(31例)与正常组(29例),再根据围产儿是否出现不良妊娠结局分为正常结局组(32例)与不良结局组(28例)。比较超声检查大脑中动脉(middle cerebral artery,MCA)及脐动脉(umbilical artery,UmA)血流情况,并对脉动指数(pulsatility index,PI)、阻力指数(resistance index,RI)、收缩期峰值/舒张末期流速(systolic peak value and the end-diastolic velocity of blood flow,S/D)指标。结果孕30周时正常组MCA的PI、RI、S/D高于缺氧组,UmA的PI、RI、S/D低于缺氧组(P<0.05);正常结局组MCA的PI、RI、S/D高于不良结局组,UmA的PI、RI、S/D低于不良结局组(P<0.05)。结论应用超声检查可有效诊断胎儿大脑中动脉及脐动脉血流宫内缺氧和分娩结局,为胎儿宫内缺氧情况采取早期预防措施提供可靠依据,可有效避免围产儿出现不良结局,临床上可借鉴及推广。展开更多
文摘The middle cerebral artery peak systolic velocity (MCA- PSV) has been successfully used for timing the first 2 transfusions in fetuses at risk for anemia because of maternal red cell alloimmunization. The Abstract of this study was to assess whether the correlation between the MCA- PSV and fetal hemoglobin is maintained in fetuses that had undergone 2 previous intrauterine transfusions. Study design: Doppler measurement of MCA- PSV was performed before cordocentesis in 39 fetuses. The timing of the third transfusion was based on traditional criteria. The values of MCA- PSV and hemoglobin were expressed as multiples of the median (MoM). Anemia was defined as mild (hemoglobin < 0.84 MoM for a given gestational age, moderate (hemoglobin < 0.65 MoM), and severe (hemoglobin < 0.55 MoM). Regression analysis was used to assess the correlation between the MCA- PSV MoM and fetal hemoglobin MoM. Results: Gestational age at Doppler study ranged from 22 to 35 weeks. Six fetuses (15% ) had normal hemoglobin concentration; 21 (53% ) had mild anemia; 7 (20% ) had moderate anemia; and 5 (12% ) had severe anemia. There was a linear correlation between fetal hemoglobin (y) and the MCA- PSV (x): y = 1.185 - 0.341x. Conclusion: Previously, concerns have been expressed about the accuracy of Doppler prediction of anemia after previous transfusions. Our data suggest that there is a good correlation between the MCA- PSV and fetal hemoglobin in fetuses that have undergone 2 previous transfusions. Our findings expand the clinical situation in which Doppler can be used to monitor red cell alloimmunized pregnancies.
文摘目的探讨超声检查在胎儿大脑中动脉及脐动脉血流在胎儿宫内缺氧及分娩结局诊断中的应用价值。方法选取2020年8月—2022年2月广东省中山市东凤人民医院收治的孕妇60例,根据是否出现宫内缺氧分为缺氧组(31例)与正常组(29例),再根据围产儿是否出现不良妊娠结局分为正常结局组(32例)与不良结局组(28例)。比较超声检查大脑中动脉(middle cerebral artery,MCA)及脐动脉(umbilical artery,UmA)血流情况,并对脉动指数(pulsatility index,PI)、阻力指数(resistance index,RI)、收缩期峰值/舒张末期流速(systolic peak value and the end-diastolic velocity of blood flow,S/D)指标。结果孕30周时正常组MCA的PI、RI、S/D高于缺氧组,UmA的PI、RI、S/D低于缺氧组(P<0.05);正常结局组MCA的PI、RI、S/D高于不良结局组,UmA的PI、RI、S/D低于不良结局组(P<0.05)。结论应用超声检查可有效诊断胎儿大脑中动脉及脐动脉血流宫内缺氧和分娩结局,为胎儿宫内缺氧情况采取早期预防措施提供可靠依据,可有效避免围产儿出现不良结局,临床上可借鉴及推广。
