Anemia (Jan 2013)

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

  • Zilma Silveira Nogueira Reis,
  • Gabriel Costa Osanan,
  • Tiago Lanfernini Ricardo Coelho,
  • Cezar Alencar De Lima Rezende,
  • Henrique Vitor Leite,
  • Antônio Carlos Vieira Cabral

DOI
https://doi.org/10.1155/2013/351258
Journal volume & issue
Vol. 2013

Abstract

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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 7.0 g/dL and hemoglobin concentration 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.