Introduction/Background During administration of chemotherapy in pregnancy, the fetus is at risk of developing fetal anemia. Severe fetal anemia may cause hydrops and possibly fetal demise. Therefore, there is a need of regular monitoring within the chemotherapy treatment. Aim of this study is to identify and monitor fetal anemia using Middle Cerebral Artery Peak Systolic Velocity during administration of chemotherapy in pregnancy.
Methodology In this prospective study, 15 patients were diagnosed with cancer in pregnancy and were treated with chemotherapy. Middle Cerebral Artery Peak Systolic Velocity (MCA-PSV) was used to establish whether the fetus is anemic. Patients were scheduled for ultrasound examination of MCA-PSV – 1st on the day of the administration of chemotherapy, 2nd examination on the 10th day after the administration. The measurement technique according to Mari et Barr was used. Multiples of median (MoM) were calculated using Medicina Fetal Barcelona calculators. According to value of MoM, the severity of anemia is determined. When moderate or severe anemia is identified, in selected cases the administration of chemotherapy is postponed. Also, newborn blood count was performed right after delivery.
Results Fetal anemia was detected in 4 patients. Using MCA-PSV, we have detected moderate fetal anemia in 2 patients and severe fetal anemia in 1 patient. In 2 patient, mild anemia was detected using newborn blood count. In 1 patient, chemotherapy administration was postponed because of detection of moderate fetal anemia, in 2 patients the treatment protocol was modified.
Conclusion In all 4 fetal anemia cases, the combination of chemotherapy agents, cisplatin and iphosphamide, was used as treatment. In other drug combinations, there was no fetal anemia detected. We suggest that for chemotherapy-induced fetal anemia, MCA-PSV is reliable method for fetal anemia monitoring and should be included into the treatment protocol.
Disclosures No conflict of interest (all authors)
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