Vol.12, No 2, 2005 pp. 93 - 96
UC 616.155.194-055.26:618.29
MATERNAL ANEMIA AND FETAL CEREBRAL
HEMODYNAMIC
RESPONSE - DOPPLER ASSESSMENT
Milan Stefanović, Mileva Milosavljević, Dragana Radović-Janošević,
Ranko Kutlešić, Predrag Vukomanović
Department of Obstetrics and Gynaecology, Clinical Center Niš, Serbia
and Montenegro
Summary. The aim of this study was to evaluate the fetal
vascular
adaptation to moderate and severe maternal anemia. Biometry, amniotic
fluid
index, uterine, cerebral and umbilical Doppler, and maternal hemoglobin
level were measured at admission and 10 days after treatment. Results:
Group 1 consisted of 18 pregnancies (maternal hemoglobin level > 60
g/L);
Group 2 consisted of 14 pregnancies (maternal hemoglobin level < 60
g/L). At admission the cerebral and cerebral/umbilical Doppler index,
amniotic
fluid index, and biometry were lower in Group 2. The uterine index was
normal in both groups. An abnormal fetal heart rate was found only in
Group
2 (57.14%). At day 10, maternal hemoglobin level and amniotic fluid
index
was higher in Group 2 than in Group 1. The cerebral index and the
cerebral-to-umbilical
resistance ratio increased only in Group 2. The abnormal fetal heart
rate
disappeared in Group 2. Conclusion: Only severe maternal anemia
(maternal
hemoglobin level < 60 g/L) triggered fetal cerebral vasodilatation
and
reduced amniotic volume.
Key words: Maternal anemia, fetus, amniotic fluid volume,
Doppler
MATERNALNA ANEMIJA I FETALNI
CEREBRALNI
HEMODINAMSKI ODGOVOR - DOPLER MERENJA
Kratak sadržaj: Svrha ove studije je ispitavanje vaskularne
adaptacije
fetusa na umerenu i tešku anemiju majke. Nivo maternalnog hemoglobina,
biometrija, količina plodove vode, uterini, cerebralni i protok kroz
pupčanik
ispitan je Dopler ultrazvučnom pretragom na prijemu i 10 dana nakon
terapije.
Rezultati: Grupu 1 čini 18 trudnica (nivo maternalnog hemoglobina >
60
g/L); grupu 2 čini 14 trudnica (nivo maternalnog hemoglobina < 60
g/L).
Na prijemu su cerebralni, cerebralni/umbilikalni Dopler indeksi, indeks
količine plodove vode, i biometrija bili niži u grupi 2. Uterini Dopler
indeksi bili su normalni u obe grupe. Patološki CTG zapis ustanovljen
je
samo u grupi 2 (57,14%). Nakon 10 dana, nivo maternalnog hemoglobina i
indeks količine plodove vode porasli su više u grupi 2. Cerebralni
indeks
i cerebralni/umbilikalni odnos indeksa otpora raste samo u grupi 2.
Patološki
CTG zapis više nije prisutan u grupi 2. Zaključak: Samo je teška
maternalna
anemija (nivo maternalnog hemoglobina < 60 g/L) pokretač fetalne
cerebralne
vazodilatacije i uzrok smanjenja količine plodove vode.
Ključne reči: Maternalna anemija, fetus, plodova voda, Dopler
