Middle cerebral artery-peak systolic velocity in dizygotic twins with anti-E alloimmunization.
J Obstet Gynaecol Res
; 36(6): 1236-9, 2010 Dec.
Article
en En
| MEDLINE
| ID: mdl-21040209
ABSTRACT
Middle cerebral artery-peak systolic velocity (MCA-PSV) has been reported to predict fetal anemia with similar accuracy as amniotic ΔOD450 assay. Alloimmunized dizygotic twin pregnancy allows us to compare anemic and non-anemic twins in the same intrauterine environment. We herein present a case of Rh (E)-incompatible dizygotic twin pregnancy, where MCA-PSV could precisely detect the anemia in one of the twins. A 36-year-old woman, whose previous child required exchange transfusion due to hemolytic anemia of newborn (HFDN), conceived twins after in vitro fertilization-embryo transfer. At 24 weeks' gestation, MCA-PSV of twin A and twin B were 23.9 cm/s (0.8 multiples of median; MoM) and 30.7 cm/s (1.0 MoM), respectively. At 31 weeks' gestation, MCA-PSV values of both twins were sharply elevated to nearly 1.4 MoM. Thereafter, MCA-PSV of twin A fell to 1.0 MoM, whereas MCA-PSV of twin B exceeded 1.5 MoM at 34 weeks' gestation. Development of fetal anemia was suspected and emergency cesarean section was performed. Twin B showed moderate anemia with positive direct Coombs' test and was diagnosed as HFDN due to anti-E alloimmunization. Twin B required phototherapy and red cell transfusion, but exchange transfusion was safely obviated.
Texto completo:
1
Bases de datos:
MEDLINE
Asunto principal:
Gemelos Dicigóticos
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Incompatibilidad de Grupos Sanguíneos
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Arteria Cerebral Media
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Enfermedades Fetales
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Anemia Neonatal
Tipo de estudio:
Diagnostic_studies
/
Etiology_studies
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Prognostic_studies
Idioma:
En
Revista:
J Obstet Gynaecol Res
Año:
2010
Tipo del documento:
Article
País de afiliación:
Japón