Fetal vascular adaptation before and after treatment of severe maternal anemia in pregnancy

Abstract Objectives To use color Doppler ultrasonography indices to study the effects on fetal circulation of treating severe maternal anemia. Methods A prospective cohort study enrolled patients who were at 30–34 weeks of pregnancy and had hemoglobin levels below 70 g/L between November 1, 2011 and March 31, 2013 at a hospital in New Delhi, India. A control group consisting of patients with the same duration of pregnancy and with hemoglobin levels above 110 g/L was included. Umbilical artery and middle cerebral artery velocimetry were performed using color Doppler ultrasonography at admission and after 4 weeks and 6 weeks of treatment. Results The maternal anemia cohort demonstrated a significantly lower middle cerebral artery resistance index and middle cerebral/umbilical artery resistance ratio ( P < 0.001) at admission. Following 4 weeks of treatment for maternal anemia, significant increases in these parameters were observed ( P < 0.001). Conclusion Fetuses of individuals with severe maternal anemia demonstrated altered cerebral and umbilical artery flows. Normal flows were restored following treatment of maternal anemia.