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Fetal Anemia
Anne Kennedy, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Clinical Issues

          TERMINOLOGY

          • Definitions

            • Abnormal or decreased fetal red blood cells
              • Etiologies: Immune, infectious, inherited, aneuploidy, monochorionic twin complications, fetomaternal hemorrhage
              • Most commonly due to Rhesus (Rh) or other minor red cell antigen/protein incompatibility
                • Maternal antibodies cross placenta and cause lysis of fetal red blood cells, leading to fetal anemia
                • Sensitization can be from prior pregnancy

          IMAGING

          • Ultrasonographic Findings

            • MR

              DIFFERENTIAL DIAGNOSIS

                PATHOLOGY

                • General Features

                  CLINICAL ISSUES

                  • Presentation

                    • Demographics

                      • Natural History & Prognosis

                        • Treatment

                          DIAGNOSTIC CHECKLIST

                          • Reporting Tips

                            Selected References

                            1. Castleman JS et al: Red cell alloimmunization: a 2020 update. Prenat Diagn. 40(9):1099-108, 2020
                            2. Radhakrishnan P et al: Prediction of fetal anemia in subsequent transfusions: is there a need to change the threshold of the peak systolic velocity of the middle cerebral artery? Fetal Diagn Ther. 47(6):491-6, 2020
                            3. Sánchez-Durán MÁ et al: Perinatal outcomes and central nervous system abnormalities following intrauterine fetal transfusion: 17years' experience in a tertiary center. Transfusion. 60(11):2557-64, 2020
                            4. Jørgensen DS et al: Magnetic resonance imaging: a new tool to optimize the prediction of fetal anemia? Fetal Diagn Ther. 46(4):257-65, 2019
                            5. Martinez-Portilla RJ et al: Performance of fetal middle cerebral artery peak systolic velocity for prediction of anemia in untransfused and transfused fetuses: systematic review and meta-analysis. Ultrasound Obstet Gynecol. 54(6):722-31, 2019
                            6. Prefumo F et al: Fetal anemia: diagnosis and management. Best Pract Res Clin Obstet Gynaecol. 58:2-14, 2019
                            7. ACOG Practice Bulletin No. 192 summary: management of alloimmunization during pregnancy. Obstet Gynecol. 131(3):611-2, 2018
                            8. Salvi S et al: Reliability of Doppler assessment of the middle cerebral artery in the near and far fields in healthy and anemic fetuses. J Ultrasound Med. 34(11):2037-42, 2015
                            9. Society for Maternal-Fetal Medicine (SMFM). Electronic address: [email protected] et al: Society for Maternal-Fetal Medicine (SMFM) clinical guideline #8: the fetus at risk for anemia--diagnosis and management. Am J Obstet Gynecol. 212(6):697-710, 2015
                            10. Hermann M et al: Cerebral Doppler velocimetry to predict fetal anemia after more than three intravenous fetal exchange transfusions. Transfusion. 54(11):2968-73, 2014
                            11. Slaghekke F et al: Twin anemia-polycythemia sequence: diagnostic criteria, classification, perinatal management and outcome. Fetal Diagn Ther. 27(4):181-90, 2010
                            12. Yang Y et al: Homozygous alpha-thalassemia-1 presenting in a fetus without anemia. Acta Haematol. 123(4):207-9, 2010
                            Related Anatomy
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                            Related Differential Diagnoses
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                            References
                            Tables

                            Tables

                            KEY FACTS

                            • Terminology

                              • Imaging

                                • Top Differential Diagnoses

                                  • Clinical Issues

                                    TERMINOLOGY

                                    • Definitions

                                      • Abnormal or decreased fetal red blood cells
                                        • Etiologies: Immune, infectious, inherited, aneuploidy, monochorionic twin complications, fetomaternal hemorrhage
                                        • Most commonly due to Rhesus (Rh) or other minor red cell antigen/protein incompatibility
                                          • Maternal antibodies cross placenta and cause lysis of fetal red blood cells, leading to fetal anemia
                                          • Sensitization can be from prior pregnancy

                                    IMAGING

                                    • Ultrasonographic Findings

                                      • MR

                                        DIFFERENTIAL DIAGNOSIS

                                          PATHOLOGY

                                          • General Features

                                            CLINICAL ISSUES

                                            • Presentation

                                              • Demographics

                                                • Natural History & Prognosis

                                                  • Treatment

                                                    DIAGNOSTIC CHECKLIST

                                                    • Reporting Tips

                                                      Selected References

                                                      1. Castleman JS et al: Red cell alloimmunization: a 2020 update. Prenat Diagn. 40(9):1099-108, 2020
                                                      2. Radhakrishnan P et al: Prediction of fetal anemia in subsequent transfusions: is there a need to change the threshold of the peak systolic velocity of the middle cerebral artery? Fetal Diagn Ther. 47(6):491-6, 2020
                                                      3. Sánchez-Durán MÁ et al: Perinatal outcomes and central nervous system abnormalities following intrauterine fetal transfusion: 17years' experience in a tertiary center. Transfusion. 60(11):2557-64, 2020
                                                      4. Jørgensen DS et al: Magnetic resonance imaging: a new tool to optimize the prediction of fetal anemia? Fetal Diagn Ther. 46(4):257-65, 2019
                                                      5. Martinez-Portilla RJ et al: Performance of fetal middle cerebral artery peak systolic velocity for prediction of anemia in untransfused and transfused fetuses: systematic review and meta-analysis. Ultrasound Obstet Gynecol. 54(6):722-31, 2019
                                                      6. Prefumo F et al: Fetal anemia: diagnosis and management. Best Pract Res Clin Obstet Gynaecol. 58:2-14, 2019
                                                      7. ACOG Practice Bulletin No. 192 summary: management of alloimmunization during pregnancy. Obstet Gynecol. 131(3):611-2, 2018
                                                      8. Salvi S et al: Reliability of Doppler assessment of the middle cerebral artery in the near and far fields in healthy and anemic fetuses. J Ultrasound Med. 34(11):2037-42, 2015
                                                      9. Society for Maternal-Fetal Medicine (SMFM). Electronic address: [email protected] et al: Society for Maternal-Fetal Medicine (SMFM) clinical guideline #8: the fetus at risk for anemia--diagnosis and management. Am J Obstet Gynecol. 212(6):697-710, 2015
                                                      10. Hermann M et al: Cerebral Doppler velocimetry to predict fetal anemia after more than three intravenous fetal exchange transfusions. Transfusion. 54(11):2968-73, 2014
                                                      11. Slaghekke F et al: Twin anemia-polycythemia sequence: diagnostic criteria, classification, perinatal management and outcome. Fetal Diagn Ther. 27(4):181-90, 2010
                                                      12. Yang Y et al: Homozygous alpha-thalassemia-1 presenting in a fetus without anemia. Acta Haematol. 123(4):207-9, 2010