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Ultrasound Scores for Safe Detection of Severe Fetal Anemia

Ultrasound Scores for Safe Detection of Severe Fetal Anemia

LEIDEN, The Netherlands, July 12 -- Noninvasive Doppler ultrasonography is superior to traditional amniocentesis for detecting severe hemolytic fetal disease in Rh-alloimmunized pregnancies, according to an international study.

The standard test to evaluate the need for fetal transfusion in hemolytic disease is serial amniocentesis to determine bilirubin levels in amniotic fluid, but although this test is accurate, amniocentesis caries risks of membrane rupture, infection, worsening of sensitization, and fetal loss, researchers wrote in the July 13 issue of the New England Journal of Medicine.

Doppler ultrasonographic measurement of peak velocity of systolic blood flow in the middle cerebral artery also predicts severe fetal anemia, but until now this test has not been rigorously evaluated in comparison with the amniotic-fluid test, said Dick Oepkes, M.D., at Leiden University here with colleagues here and at the University of Toronto.

In a prospective, international, multicenter study carried out by the Diagnostic Amniocentesis or Noninvasive Doppler (DIAMOND) Study Group, the researchers included women with RhD- Rhc- RhE- or Fya- alloimunized pregnancies with indirect antiglobulin titers of at least 1:64 and antigen-positive fetuses.

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