Although rhesus immune globulin, also known as Rhogam, has caused a dramatic decrease in anemic fetal demise, there are still risks. An estimated one to six anemia cases occur per 1000 births each year, but only 30% of these fetuses will develop anemia that requires treatment. Previously, invasive techniques such as cordocentesis and amniocentesis were the only tests used to diagnosis a fetus at risk for anemia. Recently, anemia has been diagnosed by Doppler sonography of the middle cerebral artery velocity. The peak systolic velocities are measured and plotted on a graph to determine anemia severity. These velocities are also able to diagnose anemia in healthy fetuses by monitoring velocity increases at a certain gestational age. Timing of the first and later intravenous blood transfusions can also be determined using middle cerebral artery peak systolic velocity Doppler. This noninvasive test has no known risk to the fetus and has proven very useful in the diagnosis of fetal anemia.
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