The diagnostic and monitoring value of middle cerebral artery Doppler ultrasound in types of fetal anemia

Fetal anemia is a serious prenatal condition associated with impaired fetal growth and survival. Timely and non-invasive diagnostic options are needed for early detection and monitoring. This study aims to assess the diagnostic and monitoring capabilities of middle cerebral artery (MCA) Doppler ultrasound in the setting of varying causes and severity of fetal anemia. We performed a retrospective review of the medical records of 109 fetuses who had prenatal diagnostics at our hospital from October 2021 to October 2023. Eligible cases were categorized into a range of groups: ABO, thalassemia, mild, moderate, and severe anemia. All underwent MCA Doppler ultrasonography, and the end-diastolic velocity (EDV), peak systolic velocity (PSV), resistance index (RI), and pulsatility index (PI) measurements were collected. The fetal and severe anemia diagnostic performance was measured using receiver operating characteristic (ROC) curves. EDV, PI, and RI did not differ significantly between the anemia and healthy groups (P > 0.05). However, PSV was significantly higher in the anemia group (P < 0.05). The area under the curve (AUC) for PSV in diagnosing fetal anemia was 0.835 (P < 0.05). PSV was also significantly higher than controls in both the ABO and thalassemia groups (P < 0.05), but there was no difference in EDV, PI, or RI (P > 0.05). The increase in PSV values demonstrated a positive correlation with the increasing severity of anemia. For identification of severe anemia, the AUC of PSV was 0.769 (P < 0.05). The MCA Doppler ultrasound, especially the PSV measurement, is a safe and effective method of diagnosis and evaluation for fetal anemia. Its use in practice is valuable in prompting timely intervention and improving fetal outcomes. More multicenter studies with larger sample sizes are warranted to verify our results and facilitate more widespread clinical practice use.