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Case ReportOpen Access
Middle Cerebral Artery Peak Systolic Velocity in Fetuses with Homozygous Alpha-Thalassemia-1: Case Series
Raungrongmorakot K 
,
Chaemsaithong P
,
Chaemsaithong P Objectives: The objective of this study is to evaluate the potential usefulness of middle cerebral artery peak
systolic velocity (MCA-PSV) as a non-invasive means of detecting an anemic fetus from homozygous alphathalassemia-1
Material and Method : We observed four cases of referrals with complicated pregnancies in which the fetuses
were suspected with homozygous alpha-thalassemia-1. Three out of four cases involved hydrop fetalis, detected
through previous ultrasounds, while the remaining case was referred for prenatal diagnosis. Subsequently,
we performed a detailed ultrasound and fetal MCA-PSV in all cases, and to confirm the diagnosis, we
also performed cordocentesis.
Results: With all the four cases having the gestational age range from 18 to 27 weeks, three showed hydrop
fetalis. The remaining case, the 18-week gestational age fetus referred for prenatal diagnosis, showed an
increase in the cardiothoracic ratio without other signs of hydrop fetalis. MCA-PSV suggested the presence of
fetal anemia in all cases (with the velocity ranging from 37.3 to 62.2 cm/sec). The results obtained from
cordocentesis confirmed fetal anemia and homozygous alpha-thalassemia-1 in all cases.
Conclusion: Peak systolic velocity of fetal middle cerebral artery can predict anemia in fetus affected with
homozygous alpha-thalassemia-1 disease.
Keywords: Thalassemia, Hydrops, Middle cerebral artery peak systolic flow, Fetal anemia
systolic velocity (MCA-PSV) as a non-invasive means of detecting an anemic fetus from homozygous alphathalassemia-1
Material and Method : We observed four cases of referrals with complicated pregnancies in which the fetuses
were suspected with homozygous alpha-thalassemia-1. Three out of four cases involved hydrop fetalis, detected
through previous ultrasounds, while the remaining case was referred for prenatal diagnosis. Subsequently,
we performed a detailed ultrasound and fetal MCA-PSV in all cases, and to confirm the diagnosis, we
also performed cordocentesis.
Results: With all the four cases having the gestational age range from 18 to 27 weeks, three showed hydrop
fetalis. The remaining case, the 18-week gestational age fetus referred for prenatal diagnosis, showed an
increase in the cardiothoracic ratio without other signs of hydrop fetalis. MCA-PSV suggested the presence of
fetal anemia in all cases (with the velocity ranging from 37.3 to 62.2 cm/sec). The results obtained from
cordocentesis confirmed fetal anemia and homozygous alpha-thalassemia-1 in all cases.
Conclusion: Peak systolic velocity of fetal middle cerebral artery can predict anemia in fetus affected with
homozygous alpha-thalassemia-1 disease.
Keywords: Thalassemia, Hydrops, Middle cerebral artery peak systolic flow, Fetal anemia
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