Study On The Association Of The Fetal Anemia Due To Maternal-fetal Abo Blood Group Incompatibility With The Flow Parameters Of Fetal Intra-abdominal Umbilical Vein And Middle Cerebral Artery

Objective:To investigate the association of the fetal anemia due to maternal-fetal ABO blood group incompatibility with measuring the flow parameters of fetal intra-abdominal umbilical vein and middle cerebral artery by Color Doppler Ultrasonography.Methods:Totally119singleton pregnancies at24,32,38weeks’gestation, underwent two dimensional ultrasound and Doppler imaging,68of which at risk of maternal-fetal ABO blood group incompatibility (Blood type of the pregnancy is "O", and the husband is not "O") and51normal control cases FIUV maximum velocity (Vmax), FIUV diameter (D), MCA peak systolic velocity (PSV), MCA end diastolic velocity (EDV), MCA pulsatility index (PI), and the MCA resistance index (RI) were measured. All the pregnancies in group of at risk were tested tilter of serum IgG antibody.Results:(1) By revisiting pregnancy prognosis and checking the newborns’ cases,48cases were diagnosed as maternal-fetal ABO blood group incompatibility in68cases at risk.(2) FIUV-Vmax, FIUV-D, MCA-PSV and MCA-EDV were increased along with gestational age increasing in all fetuses. MCA-PI, MCA-RI were decreased along with gestational age increasing in all fetuses.(3) In the24weeks’gestations, there were no statistically significant difference in the FlUV-Vmax, FIUV-D, MCA-PSV, MCA-EDV, MCA-PI, MCA-RI between the two groups.(4) In the same weeks’ gestation of the3rd trimester, the group of fetuses with ABO blood group incompatibility showed higher FIUV-Vmax, FIUV-D, MCA-PSV, MCA-EDV than51normal fetuses, but there were no statistically significant difference in the MCA-PI, MCA-RI between the two groups.(5) In the3rd trimester, the group of the eficiency≥1:128showed higher MCA-PSV than the group of the efficiency1:64, but there were no statistically significant difference in the FIUV-Vmax, FIUV-D, MCA-EDV between other groups.(6) Provided MCA-PSV>65.2cm/s at38weeks’gestation,the sensitivity and specificity of MCA-PSV in prediction of fetal anemia are respectively92.85%and93.02%.Conclusion:There is clinical value using Color Doppler to monitor FIUV-Vmax, FIUV-D, MCA-PSV, MCA-EDV as to predict fetal anemia due to ABO blood group incompatibility, but MCA-PSV is more sensitive than the other parameters in prediction of fetal anemia. In the condition of eficiency≥1:128in the3rd trimester, combined with monitoring the flow velocity of FIUV and MCA, if the flow parameters increase significantly, we should draw enough attention and observation as it may point to fetal anemia.