Fetal splenic size in anemia due to rh-alloimmunization

Bahado‐Singh, Ray O.; Öz, Utku; Mari, Giancarlo; Jones, David; Paidas, Michael J.; Önderoǧlu, L.

doi:10.1016/s0029-7844(98)00250-6

Cited by 37 publications

(31 citation statements)

References 9 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Oepkes et al [8] found that splenic circumference was an excellent predictor of severe anemia (Hb deficit >5 SD from normal mean) in 44 of 47 cases, with a positive predictive value of 94%. However, though consistent with those in previous studies, our results indicated that splenic size measurement was not as excellent a predictor of anemia as seen in the reports of Oepkess et al [8] and Bahado-Singh et al [7] which was studied in late gestation. This may be due to the fact that splenic size at midpregnancy (18–22 weeks of gestation) may not be as sensitive in differentiating affected from unaffected fetuses as in later pregnancy.…”

Section: Discussionsupporting

confidence: 89%

“…Therefore, theoretically, splenic size assessment may probably be effective in identifying fetal anemia. Previous studies showed that the splenic size was highly effective in identifying fetuses affected by Rh alloimmunization [7,8]. Oepkes et al [8] found that splenic circumference was an excellent predictor of severe anemia (Hb deficit >5 SD from normal mean) in 44 of 47 cases, with a positive predictive value of 94%.…”

Section: Discussionmentioning

confidence: 99%

“…Splenic enlargement associated with extramedullary erythropoiesis secondary to fetal anemia due to either Hb Bart’s disease or Rh alloimmunization has already been known. Some authors demonstrated that the splenic size could identify affected pregnancies with high sensitivity and specificity but they included only patients in late pregnancy and focused on fetuses at risk of Rh alloimmunization [7,8]. Although the classic hydropic changes due to Hb Bart’s disease are likely to occur after 20 weeks [9], our extensive experience of prenatal diagnosis by fetal blood analysis at 16–22 weeks suggests that fetal splenic size measurement may be useful in differentiating normal from affected fetuses.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Splenic Circumference at Midpregnancy as a Predictor of Hemoglobin Bart’s Disease among Fetuses at Risk

Srisupundit

Tongprasert

Luewan

et al. 2011

Gynecol Obstet Invest

View full text Add to dashboard Cite

Objective: To determine the accuracy of splenic circumference in predicting hemoglobin (Hb) Bart’s disease among fetuses at risk at midpregnancy. Materials and Methods: Women with singleton pregnancies with a fetal risk of Hb Bart’s disease were enrolled in the study at 18–22 weeks of gestation. All underwent splenic circumference measurement before cordocentesis for fetal blood analysis. The final diagnosis used as a gold standard was based on fetal Hb typing using high-performance liquid chromatography. Results: Among all the pregnancies, the prevalence of Hb Bart’s disease was 26.1% (87/334 fetuses). Twenty-four fetuses (27.6%) had some degree of hydropic changes. Notably, of these 24, 22 showed splenomegaly as well. When hydropic fetuses were excluded, the sensitivity, specificity, positive predictive value and negative predictive value of splenic circumference in identifying affected fetuses were 68.3, 83.0, 50.6 and 91.1%, respectively. Conclusion: Splenic circumference measurement at midpregnancy may be helpful in distinguishing affected fetuses from those unaffected. Among couples at risk with normal splenic size, the risk of having an affected child is much lower, whereas the enlarged spleen places the pregnancy at a higher risk. This information may help couples decide on invasive diagnosis or a noninvasive approach.

show abstract

Section: Discussionsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Splenic Circumference at Midpregnancy as a Predictor of Hemoglobin Bart’s Disease among Fetuses at Risk

Srisupundit

Tongprasert

Luewan

et al. 2011

Gynecol Obstet Invest

View full text Add to dashboard Cite

show abstract

“…The hemoglobin deficit was calculated based on the difference between the hemoglobin expected for the gestational age and that found in the puncture. IUT was performed when the fetal hemoglobin concentration deficit was ≥5 g/dL [12]. …”

Section: Methodsmentioning

confidence: 99%

“…The second criterion was proposed by Bahado-Singh et al, published in 1998 [12]. These authors also use the concept of hemoglobin deficit as a parameter to classify the severity of anemia.…”

Section: Introductionmentioning

confidence: 99%

Diagnosis of Severe Fetal Anemia Based on Perinatal Outcomes: A Comparative Analysis of the Current Reference Values

Reis

Osanan

Coelho

et al. 2013

Anemia

View full text Add to dashboard Cite

Objectives. To compare current criteria for severe fetal anemia diagnosis. Methodology. A cohort study analyzed 105 alloimmunized fetuses that underwent cordocentesis due to risk of anemia. Concordance among the diagnostic criteria for severe fetal anemia, hemoglobin deficit >7 g/dL, hemoglobin deficit ≥5 g/dL, and hemoglobin concentration <0.55 MoM, was analyzed using Cohen's Kappa index. Perinatal mortality, fetal hydrops, and fetal acidosis were used to discuss discordances. Results. There was fair concordance among the three criteria analyzed: 0.80 (Kappa index, IC 95%: 0.67 to 0.93) when comparing hemoglobin deficit >7.0 g/dL and hemoglobin concentration <0.55 MoM criteria, 0.63 (Kappa index, IC 95%: 0.47 to 0.69) when comparing hemoglobin deficit ≥5.0 g/dL and hemoglobin deficit >7.0 g/dL reference, and 0.77 (Kappa index, IC 95%: 0.64 to 0.90) when comparing hemoglobin deficit≥5.0 g/dL and hemoglobin concentration <0.55 MoM standards. Eighteen cases were classified differently depending on the criteria used. The cut-off point of hemoglobin deficit ≥5 g/dL was the best criterion to discriminate fetuses with poor perinatal outcome in our study. Conclusions. Relevant discordances in classification of severe fetal anemia were pointed out. Some criteria may underestimate the real gravity of fetal anemia.

show abstract

Reference ranges of fetal spleen biometric parameters and volume assessed by three‐dimensional ultrasound and their applicability in spleen malformations

You

Liu

et al. 2014

Prenatal Diagnosis

View full text Add to dashboard Cite

show abstract

Fetal splenic size in anemia due to rh-alloimmunization

Abstract: Splenomegaly is sensitive for the detection of severe anemia in nonhydropic Rh sensitized cases without prior transfusion. The splenic enlargement could be explained by extramedullary erythropoiesis.

Cited by 37 publications

References 9 publications

Splenic Circumference at Midpregnancy as a Predictor of Hemoglobin Bart’s Disease among Fetuses at Risk

Splenic Circumference at Midpregnancy as a Predictor of Hemoglobin Bart’s Disease among Fetuses at Risk

Diagnosis of Severe Fetal Anemia Based on Perinatal Outcomes: A Comparative Analysis of the Current Reference Values

Reference ranges of fetal spleen biometric parameters and volume assessed by three‐dimensional ultrasound and their applicability in spleen malformations

Contact Info

Product

Resources

About