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Published on: May 5, 2018
Doppler assessment of the fetal cerebral hemodynamic response to moderate or severe maternal anemia
Gabriel Carles1, Nathalie Tobal, Pierre Raynal
1Department of Obstetrics and Gynecology, Hopital Andre-Bouron, St Laurent du Maroni, France.
Objective:
The purpose of this study was to evaluate the fetal vascular adaptation to moderate and severe maternal anemia.
Study Design:
Biometry; amniotic fluid index; uterine, cerebral, and umbilical Doppler; and maternal hemoglobin level were measured at admission and 8 days after treatment.
Results:
Group 1 consisted of 16 pregnancies (maternal hemoglobin level, 6.9 +/- 0.6 g/100 mL); group 2 consisted of 23 pregnancies (maternal hemoglobin level, 5 +/- 0.6 g/100 mL). At admission the cerebral and cerebral/umbilical Doppler indexes, amniotic index, and biometry were lower in group 2. The uterine index was normal in both groups. An abnormal fetal heart rate was found in group 2 only (48%). At day 8, maternal hemoglobin level and amniotic index increased more in group 2 than in group 1. The cerebral index and the cerebral-to-umbilical resistance ratio increased only in group 2. The abnormal fetal heart rate disappeared in group 2.
Conclusion:
Only severe maternal anemia (maternal hemoglobin level, <6 mg/L) triggered fetal cerebral vasodilation and reduced amniotic volume.
