Sumera Shahbaz


Background: Maternal alloimmunization occurs when a pregnant woman has an immunologic response to a paternally derived red-cell antigen. Fetuses with anemia have a high cardiac output and decreased blood viscosity, resulting in high blood-flow velocities that could be used in prediction of fetal anemia.


Objective: To determine the diagnostic accuracy of fetal middle cerebral artery peak systolic velocity in detection of neonatal anemia in rhesus alloimmunisation keeping neonatal hemoglobin estimation at birth as the gold standard.



Setting: Department of Radiology, Jinnah Postgraduate Medical Center, Karachi.



Materials and Method: Total 189 patients with Rhesus alloimmunization were included. Doppler examination of the middle cerebral artery was performed. Three measurements of peak systolic velocity at time of absent fetal body and breathing movements were taken, and the highest velocity level was recorded. A MCA-PSV of > 1.5 MoM was taken as positive. Sensitivity, specificity, and diagnostic accuracy were calculated. Stratification was done. P-value ≤0.05 was considered as significant.


Results: The overall mean mother’s age was 29.29±4.42 years. 55.6% neonates were male and 44.4% were female. 40.7% patients were diagnosed neonatal anemia by MCA-PSV and 40.2% by neonatal hemoglobin estimation at birth. Sensitivity, Specificity, PPV, NPV and diagnostic accuracy were 86.8%, 90.3%, 85.7%, 91.0%, and 88.8% respectively.


Conclusion: The measurements of the peak velocity of blood flow provide an accurate and noninvasive means of determining the degree of anemia.


Keywords: Diagnostic Accuracy,  Fetal Middle Cerebral Artery,  Peak Systolic Velocity, Neonatal Anemia, Rhesus Alloimmunisation

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