Middle cerebral artery peak systolic velocity in fetuses with homozygous alpha-thalassemia-1: Case series

Abstract

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 alphathalassemia- 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, detected through previous ultrasounds, while the remaining case was referred for prenatal diagnosis. Subsequently, 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.