Prediction of fetal anemia by different thresholds of MCA-PSV and delta-OD in first and second intrauterine transfusions

Our aim was to compare different thresholds of middle cerebral artery peak systolic velocity [MCA-PSV] and amniotic fluid delta optical density [Delta-OD] with fetal hemoglobin [Hb] during first and second intrauterine transfusions [IUT]. We determined serial MCA-PSV and Delta-OD in 27 red blood cell alloimmunized fetuses who needed IUT. Before the second IUT, MCA-PSV was measured. The sensitivity and specificity of MCA-PSV and Delta-OD were calculated and compared with fetal hemoglobin levels. From 27 fetuses, first time IUT MCA-PSV with a normal median value [MOM] cutoff of > 1.29 detected 60% of the moderate and 100% of the severe anemia cases. MCA-PSV of MOM > 1.5 detected none of the moderate and 93% of severe anemia cases. Delta-OD detected 50% of moderate anemic and 80% of severe anemic cases. At the second IUT, 91% of severe anemia cases were confirmed by MCA-PSV with MOM > 1.5 whereas MCA-PSV with MOM > 1.29 confirmed all cases. One case of moderate anemia was detected by MCA-PSV of MOM > 1.29 and none were detected by MCA-PSV with MOM > 1.5. Different thresholds of MCA-PSV have higher sensitivity and specificity for detecting moderate and severe fetal anemia compared with Delta-OD. It also has a high sensitivity at the second IUT

Prevalence of anemia risk factors in pregnant women in Kerman, Iran

Anemia in pregnancy is associated with increased rates of maternal and perinatal mortality. To study the prevalence and risk factors of women with anemia during pregnancy in Kerman, Iran. A retrospective cross-sectional study was performed based on 2213 pregnancies delivered during the years 2005-2007 in Kerman, Iran. Women with hemoglobinopathies such as thalassemia were excluded from analysis. Anemia was defined as hemoglobin [Hg] lower than 11 g/dl during pregnancy. Categorical variables were compared using the chi-square or Fisher's exact test. Overall, 104 [4.7%] women were anemic [Hg<11 g/dl], out of which 4.8% had severe anemia [Hg<7g/dl], 15.4% had moderate anemia [Hg=7-8.9 g/dl] and 79.8% had mild anemia [Hg= 9-10.9 g/dl]. The frequency of anemia were 5%, 3.4% and 5.7% in the first, second and third trimester, respectively. Multiparity was associated with lower hemoglobin concentration during the second/third trimester of pregnancy [p=0.03 and p<0.001, respectively]. Prevalence of anemia was significantly higher in smokers and opium users [p=0.01 and p=0.003, respectively]. Our study showed that prevalence of anemia was not high in this study. Factors associated with anemia during pregnancy were parity, smoking, opium use and not using Iron supplement