RH UYUŞMAZLIĞINA BAĞLI FETAL ANEMİNİN BELİRLENMESİNDE DOPPLER VE ULTRASOUND PAREMETRELERİ

Year 2007, Volume: 20 Issue: 3, 172 - 178, 25.06.2015

Rıza Madazli

Abstract

Amaç: Rh uyuşmazlığına bağlı fetal aneminin belirlenmesinde Doppler ve ultrason ölçümlerinin etkinliğinin değerlendirilmesi. Materyal ve Metod: Rh izoimmünizasyonu olan nonhidropik 24 fetusa ultrason ve Doppler uygulandı. Orta serebral arter pik sistolik velositesi, intrahepatik umbilikal ven maksimum velositesi, karaciğer uzunluğu ve dalak çevresi ölçümleri yapıldı. Intrauterin kan transfüzyonu öncesi elde edilen son veriler değerlendirilmeye alındı. Bulgular: 18 fetusda anemi tespit edilerek intrauterin kan transfüzyonu uygulandı, 6 fetus ise noninvaziv metodlar ile takip edilerek kan transfüzyonu uygulanmadan doğurtuldu. Orta serebral arter pik sistolik velosite ölçümü fetal anemi belirlenmesinde (%94.4) en etkili yöntem olarak tespit edildi.Intrahepatik umbilikal ven maksimum velosite, dalak çevresi ve karaciğer uzunluğunun fetal anemiyi belirlemedeki sensitiviteleri sırasıyla %72.2, %55.5 ve %50 olarak saptandı. Orta serebral arter pik sistolik velosite, intrahepatik umbilikal ven maksimum velosite, dalak çevresi ve karaciğer uzunluğunun fetal anemiyi belirlemedeki etkinlikleri ROC eğrisinin altında kalan alan olarak değerlendirildiğinde sırasıyla 0.972, 0.861, 0.667 ve 0.528 olarak tespit edildi. Sonuç: Orta serebral arter pik sistolik velosite fetal aneminin belirlenmesinde en etkili noninvaziv yöntemdir.

Anahtar Kelimeler: Rh alloimmünizasyon, Fetal anemi, Doppler, Ultrasonografi

Keywords

Rh alloimmünizasyon, Fetal anemi, Doppler, Ultrasonografi

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