A pilot study on peak systolic velocity monitoring of fetal anemia after administration of chemotherapy during pregnancy

• Published in: European journal of obstetrics & gynecology and reproductive biology Vol. 174; pp. 76 - 79
• Main Authors: Halaska, M.J, Komar, M, Vlk, R, Tomek, V, Skultety, J, Robova, H, Rob, L
• Format: Journal Article
• Language: English
• Published: Ireland Elsevier Ireland Ltd 01.03.2014
• Subjects: Adult; Anemia; Anemia - chemically induced; Anemia - diagnostic imaging; Anemia - physiopathology; Antineoplastic Agents - adverse effects; Blood Cell Count; Chemotherapy; Female; Fetal Diseases - chemically induced; Fetal Diseases - diagnostic imaging; Fetal Diseases - physiopathology; Gestational Age; Humans; Infant, Newborn; Male; Maternal-Fetal Exchange; Middle Cerebral Artery - diagnostic imaging; Obstetrics and Gynecology; Pilot Projects; Pregnancy; Pregnancy Complications, Neoplastic - drug therapy; Prospective Studies; PSV; Systole; Treatment; Ultrasonography, Prenatal; Pregnancy; Chemotherapy; PSV; Treatment; Anemia
• ISSN: 0301-2115; 1872-7654
• DOI: 10.1016/j.ejogrb.2013.12.021

Abstract Objectives To monitor fetal anemia during administration of chemotherapy to the fetus's mother. Study design Between 2007 and 2012 six patients with malignancy diagnosed during pregnancy were included in our prospective study. For evaluation of fetal anemia, peak systolic velocimetry (PSV) of the middle cerebral artery is considered the best method. The patients were repeatedly examined one day before and on the third day after the administration of chemotherapy. At least three measurements were performed and the highest value was used as appropriate. Multiples of the median (MoM) were calculated using the website http://www.perinatology.com/calculators/MCA.htm . When the MoM reached 1.29, moderate anemia was diagnosed. Results The women's average age was 30 years. The average gestational age at diagnosis was 20.7 weeks of pregnancy. Borderline fetal anemia was detected in only in one patient. After delivery newborns were examined by standard pediatric evaluation and blood count was provided. There was no evidence of any newborn anemia. Conclusions Chemotherapy administered during pregnancy is becoming more frequent due to increasing knowledge and data on such cases. Close monitoring of the fetus should be performed in specialized centers. For detection of chemotherapy-induced anemia, PSV measurement should be employed.