Delta od450 and doppler velocimetry of the middle cerebral artery peak velocity in the evaluation for fetal alloimmune hemolytic disease

which is best?

Giancarlo Mari, C. Penso, M. Sbracia, L. Kern, R. Levi D'Ancona, J. Copel

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

OBJECTIVE: To compare serial measurement of the delta OD450 with serial measurement of the middle cerebral artery peak systolic velocity (MCA-PV) in fetuses at risk for hemolytic anemia secondary to alloimmunization. MATERIAL AND METHODS: Measurements of the delta OD450 and MCA-PV were obtained in 14 alloimmunized patients. Fetal anemia was suggested by an increase in either the trend of the delta OD450 using Liley curves, or of the MCA-PV using previously published nomograms. A cordocentesis was performed only when an increase in the trend of the delta OD450 was noted. RESULTS: Thirty-six amniocenteses were performed. The trend of the delta OD450 increased in 5 fetuses who then underwent cordocentesis and were found to be anemic. In these 5 anemic fetuses there was also a simultaneous increase in the trend of the MCA-PV. The trend of the MCA-PV was stable in all of the other fetuses who did not require cordocentesis and transfusion. The delta OD450, and the MCA-PV had the same sensitivity (100%), specificity (89%), positive predictive value (83%), and negative predictive value (100%) in the diagnosis of anemia. CONCLUSIONS: Doppler velocimetry of the fetal MCA is superior to the delta OD450 in the assessment of fetal anemia secondary to alloimmunization because 1) it predicts anemia as well as the delta OD450; 2) it is noninvasive; 3) it does not have any risk of fetomaternal transplacental hemorrhage; 4) it is less expensive than the delta OD450.

Original languageEnglish (US)
JournalActa Diabetologica Latina
Volume176
Issue number1 PART II
StatePublished - Dec 1 1997
Externally publishedYes

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Rheology
Middle Cerebral Artery
Cordocentesis
Anemia
Fetus
Fetomaternal Transfusion
Nomograms
Amniocentesis
Hemolytic Anemia
Sensitivity and Specificity

All Science Journal Classification (ASJC) codes

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Endocrinology

Cite this

Delta od450 and doppler velocimetry of the middle cerebral artery peak velocity in the evaluation for fetal alloimmune hemolytic disease : which is best? / Mari, Giancarlo; Penso, C.; Sbracia, M.; Kern, L.; Levi D'Ancona, R.; Copel, J.

In: Acta Diabetologica Latina, Vol. 176, No. 1 PART II, 01.12.1997.

Research output: Contribution to journalArticle

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title = "Delta od450 and doppler velocimetry of the middle cerebral artery peak velocity in the evaluation for fetal alloimmune hemolytic disease: which is best?",
abstract = "OBJECTIVE: To compare serial measurement of the delta OD450 with serial measurement of the middle cerebral artery peak systolic velocity (MCA-PV) in fetuses at risk for hemolytic anemia secondary to alloimmunization. MATERIAL AND METHODS: Measurements of the delta OD450 and MCA-PV were obtained in 14 alloimmunized patients. Fetal anemia was suggested by an increase in either the trend of the delta OD450 using Liley curves, or of the MCA-PV using previously published nomograms. A cordocentesis was performed only when an increase in the trend of the delta OD450 was noted. RESULTS: Thirty-six amniocenteses were performed. The trend of the delta OD450 increased in 5 fetuses who then underwent cordocentesis and were found to be anemic. In these 5 anemic fetuses there was also a simultaneous increase in the trend of the MCA-PV. The trend of the MCA-PV was stable in all of the other fetuses who did not require cordocentesis and transfusion. The delta OD450, and the MCA-PV had the same sensitivity (100{\%}), specificity (89{\%}), positive predictive value (83{\%}), and negative predictive value (100{\%}) in the diagnosis of anemia. CONCLUSIONS: Doppler velocimetry of the fetal MCA is superior to the delta OD450 in the assessment of fetal anemia secondary to alloimmunization because 1) it predicts anemia as well as the delta OD450; 2) it is noninvasive; 3) it does not have any risk of fetomaternal transplacental hemorrhage; 4) it is less expensive than the delta OD450.",
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N2 - OBJECTIVE: To compare serial measurement of the delta OD450 with serial measurement of the middle cerebral artery peak systolic velocity (MCA-PV) in fetuses at risk for hemolytic anemia secondary to alloimmunization. MATERIAL AND METHODS: Measurements of the delta OD450 and MCA-PV were obtained in 14 alloimmunized patients. Fetal anemia was suggested by an increase in either the trend of the delta OD450 using Liley curves, or of the MCA-PV using previously published nomograms. A cordocentesis was performed only when an increase in the trend of the delta OD450 was noted. RESULTS: Thirty-six amniocenteses were performed. The trend of the delta OD450 increased in 5 fetuses who then underwent cordocentesis and were found to be anemic. In these 5 anemic fetuses there was also a simultaneous increase in the trend of the MCA-PV. The trend of the MCA-PV was stable in all of the other fetuses who did not require cordocentesis and transfusion. The delta OD450, and the MCA-PV had the same sensitivity (100%), specificity (89%), positive predictive value (83%), and negative predictive value (100%) in the diagnosis of anemia. CONCLUSIONS: Doppler velocimetry of the fetal MCA is superior to the delta OD450 in the assessment of fetal anemia secondary to alloimmunization because 1) it predicts anemia as well as the delta OD450; 2) it is noninvasive; 3) it does not have any risk of fetomaternal transplacental hemorrhage; 4) it is less expensive than the delta OD450.

AB - OBJECTIVE: To compare serial measurement of the delta OD450 with serial measurement of the middle cerebral artery peak systolic velocity (MCA-PV) in fetuses at risk for hemolytic anemia secondary to alloimmunization. MATERIAL AND METHODS: Measurements of the delta OD450 and MCA-PV were obtained in 14 alloimmunized patients. Fetal anemia was suggested by an increase in either the trend of the delta OD450 using Liley curves, or of the MCA-PV using previously published nomograms. A cordocentesis was performed only when an increase in the trend of the delta OD450 was noted. RESULTS: Thirty-six amniocenteses were performed. The trend of the delta OD450 increased in 5 fetuses who then underwent cordocentesis and were found to be anemic. In these 5 anemic fetuses there was also a simultaneous increase in the trend of the MCA-PV. The trend of the MCA-PV was stable in all of the other fetuses who did not require cordocentesis and transfusion. The delta OD450, and the MCA-PV had the same sensitivity (100%), specificity (89%), positive predictive value (83%), and negative predictive value (100%) in the diagnosis of anemia. CONCLUSIONS: Doppler velocimetry of the fetal MCA is superior to the delta OD450 in the assessment of fetal anemia secondary to alloimmunization because 1) it predicts anemia as well as the delta OD450; 2) it is noninvasive; 3) it does not have any risk of fetomaternal transplacental hemorrhage; 4) it is less expensive than the delta OD450.

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