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During the ultrasound examination, the gynaecologist not only assesses the growth of the foetus and its anatomy, but also measures the blood flow in various vessels. Abnormal flow in the middle cerebral artery can indicate fetal anaemia. Where does it come from and what are its consequences?
Fetal anaemia – Diagnosis
Anaemia is a too low haemoglobin concentration in the blood for a certain gestational age. Anaemia in the foetus is diagnosed on the basis of ultrasound measurements, especially of the flow in the middle cerebral artery. If anaemia is present, the maximum systolic velocity (PSV MCA) in this vessel is increased. Later signs of anaemia visible on ultrasound include fetal oedema.
Fetal anaemia – Causes
One of the most common causes of fetal anaemia is a serological conflict, mainly in the Rh system. It is also possible for anaemia to develop due to a conflict in rarer systems that are not affected by the immunoprophylaxis used during pregnancy in Rh-negative women. Causes of anaemia include parvovirus infection during pregnancy, which is extremely dangerous for the unborn baby. Anaemia can also occur in multiple pregnancies in which a TAPS or TTTS syndrome has developed.
Fetal anaemia – treatment
It is very important that the expectant mother is sent to a referral centre if fetal anaemia is suspected. In the hospitals that treat such patients, further thorough diagnostics are carried out and the cause of the anaemia that has occurred in the foetus is sought. In addition to testing for antibodies against the parvovirus or serological conflicts, a test for fetal-maternal anaemia is also carried out.
An invasive test called an umbilical cord puncture makes it possible to determine the exact haemoglobin content in the blood of the foetus and thus the degree of anaemia. Using this method, intrapartum transfusions are also performed to reduce the baby’s anaemia and are a recognised treatment for anaemia. Through regular transfusions, it is possible to prolong the duration of pregnancy and reduce the risk of serious complications in the child.
Fetal anaemia – consequences
Untreated fetal anaemia can lead to haemolytic disease of the foetus, the development of generalised oedema and consequently the risk of intrauterine necrosis of the baby. For this reason, accurate diagnosis and the implementation of appropriate treatment to prevent anaemia complications are very important.
