Middle Cerebral Artery Doppler Changes following Fetal Transfusion Performed with and without Fetal Anesthesia

Am J Perinatol. 2018 Jun;35(7):682-687. doi: 10.1055/s-0037-1613683. Epub 2017 Dec 11.


Objective: The objective of this study was to test the association between fetal intravenous anesthesia and the change in middle cerebral artery peak systolic velocity (MCA-PSV) in patients undergoing intrauterine transfusion (IUT) for suspected fetal anemia.

Study design: We retrospectively examined data from all patients who underwent IUT via umbilical cord route from 2007 to 2016. We calculated the change of the MCA-PSV multiple of median (MoM) as the difference in MCA-PSV MoM between the pre- and immediate postoperative measurements for the first IUT. The change in MCA-PSV MoM was compared between those who did and did not receive fetal anesthesia using Kruskal-Wallis' testing.

Results: Of 62 patients, 37 (59.7%) received intravenous fetal anesthesia and 25 (40.3%) did not. The change in MCA-PSV MoM did not differ between those who did and did not receive fetal anesthesia (median: 0.57 [interquartile range, IQR: +0.42 to +0.76] vs. median 0.57 [IQR: +0.40 to +0.81], p = 1.000). The relationship remained insignificant when stratifying by gestational age, length of procedure, initial MCA-PSV, and when excluding hydropic fetuses.

Conclusion: Among women undergoing IUT, there was no evidence that the use of fetal anesthesia was associated with a change in the pre- versus postoperative change in MCA-PSV MoM.

MeSH terms

  • Anemia / diagnosis*
  • Anemia / therapy
  • Anesthesia*
  • Blood Flow Velocity
  • Blood Transfusion, Intrauterine*
  • Female
  • Fetal Diseases / diagnosis*
  • Gestational Age
  • Humans
  • Linear Models
  • Middle Cerebral Artery / diagnostic imaging*
  • Pregnancy
  • Pregnancy Complications, Hematologic / diagnosis
  • Pregnancy Complications, Hematologic / therapy
  • Prenatal Care
  • Retrospective Studies
  • Ultrasonography, Doppler
  • Ultrasonography, Prenatal