Ultrasonographic surveillance in red blood cell alloimmunization

Ab, Roberts; Mitchell, Jennifer; Lake, Yvonne; Pattison, N. S.

doi:10.1067/mob.2001.112975

Cited by 30 publications

(11 citation statements)

References 15 publications

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“…The direct ultrasonographic measurement of the fetal liver, therefore, may be helpful in evaluating early stages of abnormal fetal growth. We believe that this normative data of fetal liver length may have several applications in clinical practice such as in evaluation of fetal growth in cases of intrauterine growth restriction,2 gestational diabetes,4 twin‐to‐twin transfusion syndrome,10 and in surveillance of fetal anemia due to isoimmunization1, 11, 12 or hemoglobin Bart's disease 13…”

Section: Discussionmentioning

confidence: 99%

Normal length of the fetal liver from 14 to 40 weeks of gestational age

Tongprasert

Srisupundit

Luewan

et al. 2010

J of Clinical Ultrasound

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Electronic poster abstracts prediction of SGA and IUGR may improve the identification of this at risk group and assist in customising the surveillance plan. EP14.18 Abstract withdrawn EP14.19 Objectives: To determine if fetal liver length measured at 14 to 40 weeks gestational age is significantly greater in diabetic Filipino mothers compared to non-diabetic Filipino mothers. Methods: A total of 160 pregnant women with a live singleton pregnancy between 14 to 28 weeks gestational age, seen at the Obstetrics Outpatient Department Unit-Clinical Division of the University of Santo Tomas Hospital, were included in the study. Subjects were classified into non-diabetic (122 subjects) and diabetic (38 subjects). Diabetic subjects (84% were diet-controlled) were further classified into having gestational diabetes (32 subjects) and overt diabetes (6 subjects). All subjects underwent two sonographic measurements of the fetal liver length by a single sonographer, who was blinded as to the glycemic status of the subject. Measurements were analysed using t-test to compare liver lengths between non-diabetic and diabetic subjects. Results: Analysis showed that liver lengths for diabetic subjects were larger compared to non-diabetic subjects, but was only significantly in the overt diabetic group. Conclusions: The fetal liver lengths of overt diabetic Filipino mothers at 14 to 40 weeks gestational age were significantly larger compared to non-diabetics. There was no statistical difference in fetal liver lengths in those with gestational diabetes and those who were non-diabetic. EP14.20 Pentaerithrityl tetranitrate (PETN) for secondary prevention of intrauterine growth restriction (PETN-Trial-DFG GR 1955 4-1) Objectives: Affecting approximately 10% of all pregnancies, intrauterine growth restriction (IUGR) based on impaired placental function, is the most important cause of perinatal mortality and morbidity. So far, there is no option for secondary prophylaxis once signs of insufficient transformation of the uterine arteries and mal-perfusion of the placenta are observed in the second trimester. Clinical management in pregnancies at risk is restricted to close monitoring and assessment for optimal timing of delivery. In a prospective randomised controlled trial patients eligible to such prophylaxis were given the organic nitrate pentaerythrityl-tetranitrate (PETN) (2x80 mg) or placebo (Schleussner et al, J Perinat Med 2014). Methods: We could demonstrate an absolute risk reduction of 39% (relative risk RR=0.609, 95% CI 0.367 to 1.011) for the development of IUGR or combined outcome (IUGR or death) (RR=0.615, 95% CI 0.378 to 1.000), respectively. To confirm these results a prospective randomised placebo controlled double-blinded multicentre trial was now initiated.

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Section: Discussionmentioning

confidence: 99%

Normal length of the fetal liver from 14 to 40 weeks of gestational age

Tongprasert

Srisupundit

Luewan

et al. 2010

J of Clinical Ultrasound

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“…On the other hand, fetal hematocrit can change rapidly even when morphological ultrasound scan findings are entirely normal 12 . Thus, Doppler examinations to study hemodynamic changes of the fetus may help to provide earlier evidence of fetal anemia 13 …”

Section: Discussionmentioning

confidence: 99%

Anti‐E alloimmunization in pregnancy: Management dilemmas

Mok

2003

J of Obstet and Gynaecol

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Compared to anti-D alloimmunization, anti-E alloimmunization is a less common cause of hemolytic diseases of the newborn. Being a less potent immunogen, clinical manifestations of anti-E alloimmunization are more variable and usually of less severity. However, the clinical obstetric management of these cases of anti-E alloimmunization is just as challenging. We report here the management of a patient with anti-E alloimmunization to illustrate the controversies of invasive and non-invasive monitoring in the management of such cases.

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“…The usefulness of MCA peak systolic flow to diagnose chronic fetal anemia in Rh-sensitized fetuses and fetuses affected by parvovirus B19 infection has been well described. [1][2][3][4][5][6][7][8] In addition, MCA flow velocity has been used to follow fetuses with homozygous α-thalassemia. 13 Peak systolic velocity in the fetal MCA, measured over time, has been helpful in following treatment effectiveness in conjunction with conventional fetal testing.…”

Section: Discussionmentioning

confidence: 99%

“…

oppler measurement of peak systolic velocity of fetal middle cerebral artery (MCA) blood flow provides a noninvasive method to assess the degree of anemia in fetuses with chronic anemia secondary to Rh alloimmunization or parvovirus infection. [1][2][3][4][5][6][7][8] There are 2 prior case reports of increased MCA peak systolic velocity in acute fetal anemia. 9,10 This report adds to that literature and stresses the importance of checking the MCA peak systolic velocity when acute fetal anemia is of concern to appropriately care for the anemic neonate at birth.

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confidence: 99%