2006-03-22-16 Anemia from anti-E sensitization © Bigi www.thefetus.net/
Anemia from anti-E sensibilization
Fabienne Bigi, MD
A 25-year-old-woman with positive titer of 1:256 for anti-E antibodies was referred to our unit at 38 weeks. The ultrasound findings were:
- high middle cerebral artery systolic velocity
- normal umbilical Doppler
- pericardia effusion
- dilated heart
- the thickness of the inter-ventricular septum was in the high limits
- pathological mitral Doppler with E>A
- high Vmax in the ductus venosus
- there were no hepatomegaly and splenomegaly
- normal placental thickness
The ultrasonographics findings of fetal anemia were followed by a cardiotocography that showed a sinusoidal rhythm and a moderate tachycardia (150bpm). The fetus was also not very active during the scan.
The baby was delivered in good conditions by a cesarean section (3,200g). No other anomaly was noted only a moderate pallor. The hemoglobin was 7g and the bilirubin was 99 in the second hour of life. The baby underwent a exsanguinotransfusion.
Normal umbilical Doppler
The high middle cerebral artery systolic velocity
Note the thickness of the interventricular septum (upper limit):
Abnormal Mitral Doppler with E>A
Note the dilated heart with a pericardial effusion
Ductus venosus Doppler
Note the sinusoidal rhythm and a moderate tachycardia (150bpm)
Note the normal placental thickness. There was no splenomegaly.