Middle Cerebral Artery Peak Systolic Velocity in Fetuses with Homozygous Alpha-Thalassemia-1: Case Series

Kasem Raungrongmorakot MD*, Piya Chaemsaithong MD*

Affiliation : *Department of Obstetrics and Gynecology, HRH Princess Maha Chakri Sirindhorn Medical Center, Faculty of Medicine, Srinakharinwirot University, Nakhon Nayok, Thailand

Objectives: The objective of this study is to evaluate the potential usefulness of middle cerebral artery peak systolic velocity (MCA-PSV) as a non-invasive means of detecting an anemic fetus from homozygous alpha- thalassemia-1 Material and Method : We observed four cases of referrals with complicated pregnancies in which the fetuses were suspected with homozygous alpha-thalassemia-1. Three out of four cases involved hydrop fetalis, de- tected through previous ultrasounds, while the remaining case was referred for prenatal diagnosis. Subse- quently, we performed a detailed ultrasound and fetal MCA-PSV in all cases, and to confirm the diagnosis, we also performed cordocentesis.
Results : With all the four cases having the gestational age range from 18 to 27 weeks, three showed hydrop fetalis. The remaining case, the 18-week gestational age fetus referred for prenatal diagnosis, showed an increase in the cardiothoracic ratio without other signs of hydrop fetalis. MCA-PSV suggested the presence of fetal anemia in all cases (with the velocity ranging from 37.3 to 62.2 cm/sec). The results obtained from cordocentesis confirmed fetal anemia and homozygous alpha-thalassemia-1 in all cases.
Conclusion : Peak systolic velocity of fetal middle cerebral artery can predict anemia in fetus affected with homozygous alpha-thalassemia-1 disease.

Keywords : Thalassemia, Hydrops, Middle cerebral artery peak systolic flow, Fetal anemia

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