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. 2023 Mar;51(3):417-423.
doi: 10.1002/jcu.23374. Epub 2022 Oct 13.

Qualitative analysis of Doppler assessment used for surveillance of alloimmunized individuals

Christian M Hannah  1 , Katelyn M Tessier  2 , Stephen A Contag  3
Affiliations

Qualitative analysis of Doppler assessment used for surveillance of alloimmunized individuals

Christian M Hannah et al. J Clin Ultrasound. 2023 Mar.

Abstract

Objectives: To summarize image quality variables for alloimmunized women at risk for fetal anemia. To investigate the association between image quality with the highest and median middle cerebral artery peak systolic velocity (MCA-PSV) at the last visit and fetal anemia based on hemoglobin.

Study design: This study was a qualitative retrospective analysis of 192 Doppler ultrasound images used in the detection of fetal anemia in 26 alloimmunized women seen in a Minneapolis hospital over the past 3 years. Images were graded on seven criteria found in literature.

Results: Of the images analyzed, 23 (12.0%) of the 192 met all seven image quality criteria. Using the highest MCA-PSV value, the sensitivity, and specificity were 55.6% and 94.1%, respectively. Using the median MCA-PSV value, the sensitivity, and specificity were 44.4% and 94.1%, respectively.

Conclusions: Only a minority of Doppler images meet all suggested image criteria. This could negatively impact the accuracy of the MCA-PSV measurements as indicated by the decreased sensitivity in our evaluations.

Keywords: Doppler; alloimmunization; anemia; hemolysis; isoimmunization.

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Conflict of interest statement

Disclosures: The authors report no conflict of interest

Figures

Figure 1.
Figure 1.
A representative image showing all 7 criteria that should be met in a Doppler middle cerebral artery peak systolic velocity image.
Figure 2.
Figure 2.
A representative image demonstrating the most common pitfalls, including the wall motion filter not being on the lowest setting, inadequate fetal quiescence as evidenced by varying peak morphologies, not visualizing the entire MCA, and the Doppler spectral gate not being positioned in the proximal 1/3 of the MCA.
Figure 3.
Figure 3.
Boxplot displaying range of MoM.
See this image and copyright information in PMC

Comment in

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