Resumen
Diversas investigaciones han descripto anomalías ultrasónicas en fetos portadores de alfa-talasemia-1 homocigota antes del desarrollo de hydrops fetalis: placentomegalia alrededor de las 12 semanas,1 la alteración de la proporción cardiotorácica y el espesor placentario a las 13-14 y 17-18 semanas,2 ascitis, hepatoesplenomegalia, oligoamnios y placentomegalia al final de segundo trimestre y al inicio del tercero.3 También se han observado formas características de la onda de velocidad del flujo sanguíneo, detectadas por Doppler, en las arterias umbilicales de los fetos con alfa-talasemia que evoluciona hacia el hydrops fetalis.4 Y el diámetro de la vena umbilical, la velocidad y el flujo sanguíneo en fetos con hydrops fetalis portadores de hemoglobina de Bart han resultado ser mayores que los de los fetos con hydrops fetalis producidos por otras causas.5 Por otra parte, nosotros hemos abordado el estudio de parámetros ecográficos tales como la velocidad pico del flujo en la arteria cerebral media, la velocidad máxima del flujo venoso umbilical intrahepático, la longitud del hígado y el perímetro del bazo fetales, los cuales nos han sido útiles para el diagnóstico y manejo de la anemia en embarazos con portadores de alfa-talasemia-1 homocigota.6
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Especialidades
Relacionadas: Obstetricia y Ginecología, Pediatría, Hematología, Medicina Familiar, Diagnóstico por Imágenes
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NON-INVASIVE ULTRASOUND ASSESSMENT OF ANAEMIA IN FETUSES WITH HOMOZYGOUS ALPHA-THALASSAEMIA-1
Abstract
Various ultrasound abnormalities have been described in fetuses with homozygous alpha-thalassaemia-1 before the development of hydrops fetalis: placentomegaly at about 12 weeks1, cardiothoracic ratio and placental thickness at 13-14 and 17-18 weeks2, ascites, hepatosplenomegaly, oligohydramnios and placentomegaly at the end of the second trimester and at the beginning of the third trimester.3 Characteristic Doppler blood flow velocity waveforms in the umbilical arteries have been described in fetuses with alpha-thalassaemia derived hydrops fetalis.4 Umbilical vein diameter, blood velocity and blood flow in fetuses with haemoglobin Bart\'s hydrops fetalis are found to be higher than those in fetuses with hydrops fetalis from other causes.5 We have studied other ultrasound parameters including middle cerebral artery peak flow velocity, intrahepatic umbilical venous maximum flow velocity, fetal liver length and spleen perimeter which were found to be useful in the diagnosis and management of fetal anaemia in pregnancies with fetal homozygous alpha-thalassaemia-1.6
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Bibliografía del artículo
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