Re: Ultrasound markers of fetal anemia
From: James S Smeltzer MD (gaperina@mindspring.com)
Wed Jan 27 05:22:31 1999
Addendum:
I was told by reliable sources (Josh?) at the SMFM (SPO) that VMax of the
MCA is a reliable indicator for need for invasive testing (amnio,
cordocentesis), which makes sense to me teleologically, as my subspecialty
thesis was on how great the MCA is for determining fetal reserve, but
darned if I can find the reference to prove this in medline!?? Help me out
here! - Jim S
At 09:54 PM 1/19/1999 -0600, you wrote:
>Matias,
>I fully agree with Smeltzer.
>Ideally any sensitive non-invasive method is preferred over the invasive one
>in diagnosing any fetal pathology such as fetal anemia.
>There may be isoimmunization,hemolytic anemia or twin-twin transfusion and
>the need is for fetal HC,IUT etc,.
>
>Doppler velocimetry has many limitations not yet solved.Conditions
>responsible for poor O2 carrying capacity in the fetus will definitely
>effect the haemodynamic and there may be redistribution of flow.The severity
>of the disease may vary.
>
>One may look into fetal portal vein velocity (pulsatility; in normal fetus,
>flow is continuous non-pulsatile),or renal blood flow, umbilical
>vein/MCA/ductus venous blood flow,fetal aorta flow etc., but a single
>parameter will not be useful, combination of two or more may give you a
>better picture.
>
>At the same time one must do a complete ultrasonography of fetal liver,
>spleen,placenta etc.
>
>Try to note the Doppler flow velocity changes and compare it with the
>ultrasonographic findings of the relevant viscera.
>
>It may be worthwhile doing such study.
>
>Dr.Amit Sengupta,MBBS,MD,Ph.D
>-----Original Message-----
>From: James S Smeltzer MD <gaperina@mindspring.com>
>To: Multiple recipients of list <ultrasound@talk.obgyn.net>
>Date: Tuesday, January 19, 1999 10:53 AM
>Subject: Re: Ultrasound markers of fetal anemia
>
>>Matias,
>>
>>As the Yale group has shown, there are no good markers except hydrops,
>>which indicates a need for fetal HCT and possible IUT, IMHO! Jim Smeltzer
>MD
>>
>>At 06:20 PM 1/17/1999 -0600, you wrote:
>>>Thanks Dr. Amit Sengupta for your answer, but i'm refer about ultrasound
>>>markers of fetal anemia. Are doppler markers earlier than placental
>>>morphology? What is the best doppler marker (peak velocity of mca , VCI,
>>>etc....) ?
>>>Many Thanks
>>>Matias Elena
>>>elenam@cpsarg.com
>>>Mar del Plata , Argentina
>>>
>>
>
