A Rh negative G4P3+O has an antibody level of 15 IU/ml (IAT 1 :32) at 27 weeks.What is the most appropriate next step in the management?
Ans. is c, i.e. Estimate the middle cerebral artery peak systolic velocityThe antibody titer is high the next step is to determine whether the ISO fetus is anaemic due to haemolysis. The middle cerebral artery peak systolic velocity (MCA-PSV) is the best method of assessing the fetal condition. When the fetus has developed anemia due to haemolysis, the blood viscosity decreases and the blood flow velocity will be increases. MCA peak systolic velocity value greater than 1.5 multiples of the median. If gestational age is <34 weeks, it is an indication for estimation of fetal hemoglobin by cordocentesis. Intrauterine transfusion is performed when the fetal hematocrit is less than 30%.If gestational age is >=34 weeks termination of pregnancy done.
Estimate the amniotic fluid bilirubin levels
Estimate the fetal hemoglobin levels by cordocentesis
Estimate the middle cerebral artery peak systolic velocity
Perform intrauterine transfusion
Pregnancy in Rh-negative Women