Ultrasonography in perinatal hemolytic disease

Abstract

Perinatal hemolytic disease occurs when any fetal blood group antigenic factor inherited from the father is not recognized by the mother. Antepartum or intrapartum fetal-maternal transfusion may stimulate an immune reaction in the pregnant. These maternal immune reactions also can occur from blood product transfusion. Depending on the degree of antigenicity and the amount and type of antibodies involved, the transplacental passage may lead to hemolytic disease in the fetus and neonate. Undiagnosed and untreated perinatal hemolytic disease can lead to perinatal morbidity and mortality. Fetuses at risk for severe anemia are identified on the basis of the mother’s obstetrical history and maternal serum antibody levels. Amniocentesis for the determination of bilirubin levels in amniotic fluid has been used to determine the severity of fetal hemolysis. However, this procedure carries risks to the fetuses. Doppler velocimetry of the fetal middle cerebral artery by the calculation of peak systolic velocity has been used because it is a noninvasive diagnostic method with high sensitivity and specificity for the detection of severe fetal anemia. In this context, we performed a review of perinatal hemolytic disease, with emphasis on diagnostic methods.