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Middle Cerebral Artery Doppler Used to Detect Fetal Anemia

Correspondence: Angela Lalicker, University of Nebraska Medical Center, 1310 N. 112 Ct., #6326, Omaha, NE 68154.angie_lalicker{at}hotmail.com

Jeffrey Himmelberg, MD

University of Nebraska Medical Center, Omaha, Nebraska.

Although rhesus immune globulin, also knownas Rhogam, has caused a dramatic decrease inanemic fetal demise, there are still risks. Anestimated one to six anemia cases occur per 1000births each year, but only 30% of these fetuseswill develop anemia that requires treatment.Previously, invasive techniques such ascordocentesis and amniocentesis were the only testsused to diagnosis a fetus at risk for anemia.Recently, anemia has been diagnosed by Dopplersonography of the middle cerebral arteryvelocity. The peak systolic velocities are measuredand plotted on a graph to determine anemiaseverity. These velocities are also able to diagnoseanemia in healthy fetuses by monitoring velocityincreases at a certain gestational age. Timing ofthe first and later intravenous blood transfusionscan also be determined using middle cerebralartery peak systolic velocity Doppler. Thisnoninvasive test has no known risk to the fetus andhas proven very useful in the diagnosis of fetalanemia.

Key Words: middle cerebral artery • Doppler • anemia • Rh disease • peak systolic velocities • sonography

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