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2006-03-22-16 Anemia from anti-E sensitization © Bigi www.thefetus.net/


Anemia from anti-E sensibilization

Fabienne Bigi, MD

France

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.

 

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