Effect of maternal anemia on fetal Doppler indices during the last trimester of pregnancy

Abstract

Background: Anemia is one of the most commonly encountered medical disorders during pregnancy. In developing countries it is a cause of serious concern as, besides many other adverse effects on the mother and the fetus it contributes significantly to high maternal mortality. According to United Nation declaration 1997, anemia is a major public health problem that needs total elimination. It is estimated that globally two billion people suffer from anemia or iron deficiency.Maternal anemia is frequently associated with premature delivery, reduced neonatal weight, infant iron deficiency, neonatal death, and low APGAR scores at 1 min. It is also suspected to reduce the oxygen supply to the growing fetus, leading to the redistribution of fetal blood flow. Objective: The aim of this study was to evaluate the effect of maternal anemia on fetal Doppler indices namely umbilical artery and middle cerebral artery in the last trimester of pregnancy. Patients and Methods: This study was designed as a prospective case control clinical trial carried out in Obstetric outpatient clinics and inpatient ward, Ain Shams University Maternity Hospital on 200 patients. The patients must follow these criteria, gestational age between 28-40 weeks of singleton pregnancy (calculated by their last menstrual period or by earlier ultrasound), fetus is alive and normal fetal ultrasound parameters. Results: The umbilical artery resistance index show a significant increase in moderate severe anemic patients more than control group, umbilical artery pulsatility index show a significant increase in severe anemic group more than the other 3 groups, umbilical artery systolic/diastolic ratio show a significant increase in severe anemic more than the other groups. Finally the umbilical artery cerebral/umbilical artery resistance ratio show a significant increase in severe anemic more than the other groups. Conclusion: GA at delivery in in different groups was matched. i.e. there was no statistical significant difference between different studied groups regarding GA at delivery (P > 0.05). Neonatal ICU admission were 2(4%), 2(4%), 4(8%) and 9(18%) in different groups respectively. There was statistical significant difference between different studied groups regarding Neonatal ICU admission (P < 0.05).