A noninvasive method for the prediction of fetal hemolytic disease
https://doi.org/10.21508/1027-4065-2017-62-2-39-44
Abstract
Objective: to improve the diagnosis of fetal hemolytic disease.
Subjects and methods. A study group consisted of 42 pregnant women whose newborn infants had varying degrees of hemolytic disease. The women were divided into 3 subgroups according to the severity of neonatal hemolytic disease: 1) pregnant women whose neonates were born with severe hemolytic disease (n = 14); 2) those who gave birth to babies with moderate hemolytic disease (n = 11); 3) those who delivered infants with mild hemolytic disease (n = 17). A comparison group included 42 pregnant women whose babies were born without signs of hemolytic disease. Curvesfor blood flow velocity in the middle cerebral artery were analyzed in a fetus of 25 to 39 weeks’ gestation.
Results. The peak systolic blood flow velocity was observed in Subgroup 1; however, the indicator did not exceed 1.5 MoM even in severe fetal anemic syndrome. The fetal middle artery blood flow velocity rating scale was divided into 2 zones: 1) the boundary values of peak systolic blood flow velocity from the median to the obtained midscore; 2) the boundary values of peak systolic blood flow velocity of the obtained values of as high as 1.5 MoM.
Conclusion. The value of peak systolic blood flow velocity being in Zone 2, or its dynamic changes by transiting to this zone can serve as a prognostic factor in the development of severe fetal hemolytic disease.
About the Authors
E. N. Kravchenko
Omsk State Medical University, Ministry of Health of Russia
Russian Federation
Omsk
Russian Federation
Omsk
M. A. Ozherelyeva
Omsk State Medical University, Ministry of Health of Russia
Russian Federation
Omsk
Russian Federation
Omsk
L. V. Kuklina
Omsk State Medical University, Ministry of Health of Russia
Russian Federation
Omsk
Russian Federation
Omsk
References
1. Савельева Г.М. Некоторые актуальные вопросы акушерства. Акушерство и гинекология 2006; (3): 3–7. [Savel’eva G.M. Some actual problems of obstetrics. Akusherstvo i ginekologija 2006; (3): 3–7. (in Russ)]
2. Urgessa F., Tsegaye А., Gebrehiwot Y., Birhanu A. Assessment of feto-maternal hemorrhage among rhesus D negative pregnant mothers using the kleihauer-betke test (KBT) and flow cytometry (FCM) in Addis Ababa, Ethiopia. BMC Pregnancy Childbirth 2014; 14: 1: 358. DOI: 10.1186/1471-2393-14-358.
3. British Committee for Standards in Haematology. http://www.bcshguidelines.com/documents/AntiD_bcsh_07062006.pdf.
4. Айламазян Э.К., Павлова Н.Г. Изоиммунизация при беременности. Санкт-Петербург: Н-Л, 2012; 27. [Ajlamazjan Je.K., Pavlova N.G. Of isoimmunisation during pregnancy. St. Petersburg: N-L, 2012; 27. (in Russ)]
5. Papantoniou N., Sifakis S., Antsaklis A. Therapeutic management of fetal anemia: review of standard practice and alternative treatment options. J Perinat Med 2013; 41: 1: 71-82. DOI: 10.1515/jpm-2012-0093.
6. Ожерельева М.А., Кравченко Е.Н., Ветров В.В., Иванов Д.О., Куклина Л.В. Профилактика гемолитической болезни плода и новорожденного и ее тяжелых форм при резус-конфликте (обзор литературы). Детская медицина Северо-Запада 2015; 6: (3): 42–48. [Ozherel’eva M.A., Kravchenko E.N., Vetrov V.V., Ivanov D.O., Kuklina L.V. Prevention of hemolytic disease of the fetus and newborn and its severe forms with RH conflict (literature review). Detskaja medicina Severo-Zapada 2015; 6: (3): 42–48. (in Russ)]
7. Павлова Н.Г., Шелаев Е.В., Нагорнева С.В. Доплерометрия мозгового кровотока плода для диагностики тяжелых форм гемолитической болезни. Пренатальная диагностика 2007; 6: (3):175–179. [Pavlova N.G., Shelaev E.V., Nagorneva S.V. Doppler study of fetal cerebral blood flow for the diagnosis of severe forms of hemolytic disease. Prenatal’naja diagnostika 2007; 6: (3): 175–179. (in Russ)]
8. Picklesimer A.H.1 , Oepkes D., Moise K.J. Determinants of the middle cerebral artery peak systolic velocity in the human fetus. Am J Obstet Gynecol 2007; 197: (526): 1–4. DOI: 10.1016/j.ajog.2007.04.002.
9. Mari G., Deter R.L., Carpenter R.L. 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. N Engl J Med 2000; 342: (1): 9–14. DOI: 10.1056/NEJM200001063420102.
10. Samson J., Block D., Mari G. Middle cerebral artery Doppler for managing fetal anemia. Clin. Obstet. Gynecol 2010; 53: (4): 851–857. DOI: 10.1097/GRF.0b013e3181fbaf6d.
11. Пренатальная эхография. Под ред. М.В. Медведева. Москва: Реальное время 2005; 560. [Prenatal echography. Editor M. V. Medvedev. Moscow: Real’noe vremja 2005; 560. (in Russ)]
12. Lubuský M., Procházka M., Santavý J. Actual management of pregnancies at risk for fetal anemia. Ceska Gynekol 2006; 71: (4): 272–280.
13. Mari G., Zimmermann R., Moise K.J.Jr. Correlation between middle cerebral artery peak systolic velocity and fetal hemoglobin after 2 previous intrauterine transfusions. Am J Obstet Gynecol 2005; 193: (3): 1117–1120. DOI: http://dx.doi.org/10.1016/j.ajog.2005.06.078.
14. Mandic V., Mikovic Z., Filimonović D. Noninvasive diagnosis of fetal anemia in Rh-alloimmunized pregnancies by color Doppler. Med Pregl 2005; 58: (5–6): 275-278.
15. Moise K.J., Moise K.J.Jr. The usefulness of middle cerebral artery Doppler assessment in the treatment of the fetus at risk for anemia. Am J Obstet Gynecol 2008; 198: (2): 161. DOI: http://dx.doi.org/10.1016/j.ajog.2007.10.788.
16. Oepkes D., Seaward P. G., Frank P. Doppler ultrasonography versus amniocentesis to predict fetal anemia. N Eng J Med 2006; 355 (2): 156–164. DOI: 10.1056/NEJMoa052855.
17. Moise K.J.Jr., Moise K.J. Diagnosing hemolytic disease of the fetus – time to put the needles away? N Eng J Med 2006; 355 (2): 192–194. DOI: 10.1056/NEJMe068071.
18. Bennardello F., Coluzzi S., Curciarello G. Recommendations for the prevention and treatment of haemolytic disease of the foetus and newborn. Blood Transfus 2015; 13: (1): 109–134. DOI: 10.2450/2014.0119–14.
19. Абдрахманова Л.Р., Токтарова О.А., Ситарская М.В., Мусина Д.М. Анализ результатов доплерометрического исследования кровотока в средней мозговой артерии у плода при резус-иммунизации. Практическая медицина 2015; 4(89); 7–9. [Abdrahmanova L.R., Toktarova O.A., Sitarskaja M.V., Musina D.M. Аnalysis of the results diplomaticheskogo the study of blood flow in the middle cerebral artery in a fetus with RH-immunization. Prakticheskaja medicina 2015; 4(89); 7–9. (in Russ)]
20. Найденова И.Е., Сичинава Л.Г. Диагностическая ценность изменений максимальной систолической скорости кровотока в средней мозговой артерии при гемолитической болезни плода. Вопр гинекол, акуш перинатол 2012; (5): 13–18. [Najdenova I.E., Sichinava L.G. The diagnostic value of changes the maximum systolic blood flow velocity in the middle cerebral artery in hemolytic disease of the fetus. Vopr ginekol, akush perinatol 2012; (5): 13–18. (in Russ)]
21. Зайцев В.М., Лифляндский В.Г., Маринкин В.И. Прикладная медицинская статистика. СПб: Фолиант 2003; 432. [Zajcev V.M., Lifljandskij V.G., Marinkin V.I. Applied medical statistics. SPb.: Foliant, 2003; 432. (in Russ)]
Review
For citations:
Kravchenko E.N., Ozherelyeva M.A., Kuklina L.V. A noninvasive method for the prediction of fetal hemolytic disease. Rossiyskiy Vestnik Perinatologii i Pediatrii (Russian Bulletin of Perinatology and Pediatrics). 2017;62(2):39-44. (In Russ.) https://doi.org/10.21508/1027-4065-2017-62-2-39-44
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