Abstract
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 <0.55 MoM, was analyzed using Cohen's Kappa index. Perinatal mortality, fetal hydrops, and fetal acidosis were used to discuss discordances. Results. There was fair concordance among the three criteria analyzed: 0.80 (Kappa index, IC 95%: 0.67 to 0.93) when comparing hemoglobin deficit >7.0 g/dL and hemoglobin concentration <0.55 MoM criteria, 0.63 (Kappa index, IC 95%: 0.47 to 0.69) when comparing hemoglobin deficit ≥5.0 g/dL and hemoglobin deficit >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...Continue Reading
References
Mar 1, 1994·American Journal of Obstetrics and Gynecology·R WelchC H Rodeck
Feb 1, 1997·Obstetrical & Gynecological Survey·I Forouzan
Feb 1, 1997·Seminars in Perinatology·J Bowman
Oct 30, 1998·Obstetrics and Gynecology·R Bahado-SinghL Onderoglu
Jan 6, 2000·The New England Journal of Medicine·G MariS C Blackwell
Apr 21, 2005·Journal of Ultrasound in Medicine : Official Journal of the American Institute of Ultrasound in Medicine·Giancarlo Mari
May 28, 2005·BMJ : British Medical Journal·Sailesh Kumar, Fiona Regan
Jul 21, 2006·European Journal of Obstetrics, Gynecology, and Reproductive Biology·Luciano Marcondes Machado NardozzaEdward Araújo Junior
Sep 29, 2007·International Journal of Gynaecology and Obstetrics : the Official Organ of the International Federation of Gynaecology and Obstetrics·A C V CabralI G Melo
Sep 21, 2010·International Journal of Gynaecology and Obstetrics : the Official Organ of the International Federation of Gynaecology and Obstetrics·Antônio Carlos Viera CabralHenrique Vitor Leite
Oct 19, 2010·Transfusion and Apheresis Science : Official Journal of the World Apheresis Association : Official Journal of the European Society for Haemapheresis·Michelle J BleileThomas J Raife
Oct 23, 2010·Blood Transfusion = Trasfusione Del Sangue·Mônica Deolindo SantiagoZilma Silveira Nogueira Reis
Nov 4, 2011·The Journal of Maternal-fetal & Neonatal Medicine : the Official Journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians·Gabriel Costa OsananAntônio Carlos Vieira Cabral