Yale Bulletin and Calendar

January 28, 2000

Volume 28, Number 18

Yale team develops non-invasive
test for fetal anemia

Yale scientists have successfully used a non-invasive technology called Doppler ultrasound to detect whether or not a fetus is anemic, eliminating the risks accompanying traditional invasive tests for the deficiency.

"Invasive procedures place the fetus in unnecessary danger," says Dr. Giancarlo Mari, associate professor of obstetrics and gynecology at the School of Medicine and the study's lead author. "In more than 70% of cases, the fetuses tested were either non-anemic or mildly anemic and an invasive procedure could have been either avoided or delayed."

In one to two of every 1,000 pregnancies in the United States, there is a risk that the fetus may develop anemia, an oxygen deficiency in the blood. A fetus that develops anemia may require transfusion because he/she is at risk of dying. However, only between 10% and 20% of the fetuses at risk for anemia will develop the deficiency.

Diagnosis of fetal anemia is currently performed using invasive procedures such as amniocentesis and cordocentesis. Both carry a risk of death to the fetus. Furthermore, if an initial sample does not demonstrate anemia, the timing of repeat invasive procedures is arbitrarily determined.

In their study, published in the Jan. 6 issue of the New England Journal of Medicine, Mari and colleagues report that anemic fetuses have a higher blood flow velocity -- i.e., the rate of blood flow -- in cerebral arteries than do non-anemic fetuses. Doppler ultrasound was used to test fetal blood velocity and to gauge fetal anemia.

The assessment of fetal blood velocity with Doppler ultrasound detected all the moderately and severely anemic fetuses with a false positive rate of 15%. Doppler study can be performed in three to five minutes and does not pose any risk to the mother or the fetus. The procedure is also far less expensive than amniocentesis and cordocentesis.

"By using Doppler ultrasound to assess the velocity of blood flow, we can save about $50 million each year in the United States alone," says Mari. "The procedure is also easy to perform in the hands of experienced operators."

The data used in the study was compiled at eight medical centers in the United States, Europe, South America and Asia.

-- By Karen Peart

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