Ultrasound

  • 1.  MCA Doppler for fetal anemia

    Posted 10-21-2021 18:54
    Our practice has utilized the Phillips platform for OB imaging for some time. In the last year we have noticed a discrepancy with PSV and fetal hematocrit at time of PUBS. It appears to be independent of sonographer, MFM, and appropriate technique has been confirmed. We have seen lower values on the GE platform at our inpatient unit which are correlating with the fetal HCT. Has anyone else noticed this issue? I have reached out to Phillips but the solutions they provided did not resolve the discordance.


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    Ashlie Tronnes, MD

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  • 2.  RE: MCA Doppler for fetal anemia

    Posted 10-22-2021 18:18
    Phillips has very sensitive Doppler. For this reason may people prefer these over GE if you do very Doppler intensive work like echo. Not surprising it overestimates Psv. You probably capture the top of the curve while is likely an artifact and overestimate degree of anemia. I assume that you use 0 degree correction with appropriate gate for sampling.  You may was to adjust pulse wave gain and prf settings to match ge results.  On one patient use both machines until getting similar values as ge.   You may want to see original papers by Mari for setting they used to establish normal curves.

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    Dimitry Zilberman
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  • 3.  RE: MCA Doppler for fetal anemia

    Posted 10-23-2021 19:22
    We have seen the same problem with the GE E10.  I believe that the newer technology is more sensitive and therefore picking up the subpopulation of higher velocity RBC's.  The question is can the new machines be adjusted (aka dumbed down) to the level of the older technology; or do we all need to have on hand an older machine (not as old as the ones used by Mari) for MCA PSV measurement.   

    Jeffrey Wright, MD FACOG
    Maternal Fetal Medicine





  • 4.  RE: MCA Doppler for fetal anemia

    Posted 10-24-2021 19:13
    As far as Phillip's sensitivity, perhaps one can open up the wall filter so that it does. not capture the wall motion of the vessel. Also, I generally do not rely on the machine to calculate the PSV when the MoM is elevated/borderline. I also think there is an ascertainment bias that we are seeing as well with a decrease in the specificity of the finding of an elevated PSV (due to hyperdynamic cardiac output, etc.). Hope this is all food for thought.

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    Allan FISHER
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  • 5.  RE: MCA Doppler for fetal anemia

    Posted 10-22-2021 18:47
    Yes we noticed the same for some time now and was brought up to Philips attention!
    Moustafa M. Hassan, MD.
    President and CEO
    Maternal Fetal Associates Of The Mid-Atlantic, LLC.
    1850 Town Center Parkway, suite 258
    Pavillion II 
    Reston, VA 20190
    Tel: 703-435-1454
    Fax: 703-435-8630
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  • 6.  RE: MCA Doppler for fetal anemia

    Posted 10-28-2021 19:45
    Thank you all for your comments and suggestions.

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    Ashlie Tronnes
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