{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,26]],"date-time":"2026-10-26T23:25:39Z","timestamp":1793057139657,"version":"4.5.0"},"reference-count":55,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2019,12,4]],"date-time":"2019-12-04T00:00:00Z","timestamp":1575417600000},"content-version":"vor","delay-in-days":3,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Ultrasound in Obstet &amp; Gyne"],"published-print":{"date-parts":[[2019,12]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To evaluate the performance of fetal middle cerebral artery peak systolic velocity (MCA\u2010PSV) \u2265\u20091.5 multiples of the median (MoM) for the prediction of moderate\u2013severe anemia, in untransfused and transfused fetuses.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A systematic search was performed to identify relevant observational studies reported in the period 2008\u20132018 that evaluated the performance of MCA\u2010PSV, using a threshold of 1.5\u2009MoM for the prediction of fetal anemia. Diagnosis of fetal anemia by blood sampling was the reference standard. A hierarchical summary receiver\u2013operating characteristics (hSROC) curve was constructed using random\u2010effects modeling. Subgroup and meta\u2010regression analyses, according to the number of previous intrauterine transfusions, were performed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Twelve studies and 696 fetuses were included in the meta\u2010analysis. The area under the hSROC curve (AUC) for moderate\u2013severe anemia was 83%. Pooled sensitivity and specificity (95%\u2009CI) were 79% (70\u201386%) and 73% (62\u201382%), respectively, and positive and  negative likelihood ratios were 2.94 (95%\u2009CI, 2.13\u20134.00) and 0.272 (95%\u2009CI, 0.188\u20130.371). When considering only untransfused fetuses, prediction improved, achieving an AUC of 87%, sensitivity of 86% (95%\u2009CI, 75\u201393%) and specificity of 71% (95%\u2009CI, 49\u201387%). A decline in sensitivity for the prediction of moderate\u2013severe anemia by MCA\u2010PSV \u22651.5\u2009MoM was observed (estimate, \u20135.5% (95%\u2009CI, \u201310.7 to \u20130.3%), <jats:italic>P<\/jats:italic>\u2009=\u20090.039) as the number of previous transfusions increased.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>MCA\u2010PSV \u2265\u20091.5\u2009MoM for the prediction of moderate\u2013severe anemia in untransfused fetuses shows moderate accuracy (86% sensitivity and 71% specificity), which declines with increasing number of intrauterine transfusions. Copyright \u00a9 2019 ISUOG. Published by John Wiley &amp; Sons Ltd.<\/jats:p><\/jats:sec>","DOI":"10.1002\/uog.20273","type":"journal-article","created":{"date-parts":[[2019,4,1]],"date-time":"2019-04-01T12:13:28Z","timestamp":1554120808000},"page":"722-731","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":73,"title":["Performance of fetal middle cerebral artery peak systolic velocity for prediction of anemia in untransfused and transfused fetuses: systematic review and meta\u2010analysis"],"prefix":"10.1002","volume":"54","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4711-3857","authenticated-orcid":false,"given":"R. 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R.","family":"Villafan\u2010Bernal","sequence":"additional","affiliation":[{"name":"Mexican Consortium of Biomedicine Biotechnology and Health Dissemination\u2010Consortium BIO2\u2010DIS  Mexico"},{"name":"CONACYT Researcher, Department of Surgery, Health Science Center Autonomous University of Aguascalientes  Aguascalientes Mexico"},{"name":"Center for Health Sciences Autonomous University of Aguascalientes  Aguascalientes Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"F.","family":"Paz y Mi\u00f1o","sequence":"additional","affiliation":[{"name":"Fetal Medicine Research Center, BCNatal, Barcelona Center for Maternal\u2010Fetal and Neonatal Medicine (Hospital Cl\u00ednic and Hospital Sant Joan de Deu), Institut Cl\u00ednic de Ginecologia, Obstetricia i Neonatologia Universitat de Barcelona  Barcelona Catalonia Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"F.","family":"Figueras","sequence":"additional","affiliation":[{"name":"Fetal Medicine Research Center, BCNatal, Barcelona Center for Maternal\u2010Fetal and Neonatal Medicine (Hospital Cl\u00ednic and Hospital Sant Joan de Deu), Institut Cl\u00ednic de Ginecologia, Obstetricia i Neonatologia Universitat de Barcelona  Barcelona Catalonia Spain"},{"name":"Center for Biomedical Research on Rare Diseases (CIBER\u2010ER)  Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4304-4797","authenticated-orcid":false,"given":"A.","family":"Borrell","sequence":"additional","affiliation":[{"name":"Prenatal Diagnosis Unit Hospital Cl\u00ednic de Barcelona, Universitat de Barcelona  Barcelona Catalonia Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,12,4]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM200001063420102"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9378(88)90413-9"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1159\/000116737"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.siny.2008.02.007"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.14925"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/trf.12714"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1159\/000323821"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0b013e31826d7dc1"},{"issue":"141","key":"e_1_2_7_10_1","first-page":"e1","article-title":"Long\u2010term neurodevelopmental outcome after intrauterine transfusion for hemolytic disease of the fetus\/newborn: the LOTUS study","volume":"206","author":"Lindenburg IT","year":"2012","journal-title":"Am J Obstet Gynecol"},{"issue":"204","key":"e_1_2_7_11_1","first-page":"e1","article-title":"Intrauterine transfusion for parvovirus B19 infection: long\u2010term neurodevelopmental outcome","volume":"206","author":"De Jong EP","year":"2012","journal-title":"Am J Obstet Gynecol"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0029-7844(01)01783-5"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa052855"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(88)91896-X"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijgo.12318"},{"key":"e_1_2_7_16_1","first-page":"584","article-title":"Foetal peak systolic velocity in the middle cerebral artery: an Asian reference range","volume":"50","author":"Tan KB","year":"2009","journal-title":"Singapore Med J"},{"key":"e_1_2_7_17_1","first-page":"29","article-title":"Doppler waveform indices of fetal middle cerebral artery in normal 20 to 40\u2009weeks pregnancies","volume":"12","author":"Tarzamni MK","year":"2009","journal-title":"Arch Iran Med"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1002\/pd.3966"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.2009.02255.x"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.15762"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2009.06.005"},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-155-8-201110180-00009"},{"key":"e_1_2_7_23_1","unstructured":"The Nordic Cochrane Centre TCC. 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