In a G2P1, Rh negative mother with previous history of hydrops fetalis, now ICT is positive at 20 weeks. What is the next line of management?
Correct Answer: MCA Doppler
Description: Hydrops fetalis in the previous pregnancy and positive ICT now is suggestive of maternal isoimmunisation Now the next step is to quantify fetal anemia/ fetal hemolysis. This is best done by MCA PSV measurement on fetal doppler since it is very sensitive and non invasive. Methods for detection of fetal anemia are: MCA peak systolic velocity: very sensitive, non invasive Amniocentesis and bilirubin estimation: invasive Cordocentesis: most invasive technique , associated with fuher fetoplacental bleed, thrombosis, fetal bradycardia and IUD. Hence not preferred. Done in cases of: fetal hydrops Zone 3 on Liley's cha MCA PSV of >1.5 MoM Intrauterine Exchange transfusion: Done when fetal hematocrit on cordocentesis is < 30 %
Category:
Gynaecology & Obstetrics
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