Middle Cerebral Artery Peak Systolic Velocity in Fetuses with Homozygous Alpha-Thalassemia-1: Case Series
Kasem Raungrongmorakot MD*, Piya Chaemsaithong MD*
Affiliation : *Department of Obstetrics and Gynecology, HRH Princess Maha Chakri Sirindhorn Medical Center, Faculty of Medicine, Srinakharinwirot University, Nakhon Nayok, Thailand
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 alpha-
thalassemia-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, de-
tected through previous ultrasounds, while the remaining case was referred for prenatal diagnosis. Subse-
quently, 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
