{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,6]],"date-time":"2026-05-06T13:44:46Z","timestamp":1778075086050,"version":"3.51.4"},"reference-count":20,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2006,8,29]],"date-time":"2006-08-29T00:00:00Z","timestamp":1156809600000},"content-version":"vor","delay-in-days":0,"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":[[2006,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To assess the role of peak systolic velocity in the middle cerebral artery (MCA\u2010PSV) in the management of pregnancies complicated by Kell isoimmunization.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Sixteen fetuses were monitored by conventional protocol (Group 1) and eight fetuses by an MCA\u2010PSV\u2010guided protocol (Group 2). The conventional protocol included a weekly ultrasound evaluation and measurement of maternal anti\u2010Kell titers every 4\u20136 weeks. In Group 2 Doppler assessment of the MCA\u2010PSV was performed at intervals of 4 to 7 days and MCA\u2010PSV &gt; 1.5 multiples of the median (MoM) was considered as an indication for fetal blood sampling (FBS).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>No parameter emerged as a reliable predictor of isoimmunization severity in Group 1. In Group 2, no FBS was necessary in one case since the MCA\u2010PSV values obtained during the follow\u2010up were &lt; 1.29 MoM. In two cases the first FBS was already indicated after 1 week of follow\u2010up, but five other fetuses were followed for 3\u20139 weeks before FBS was indicated. All fetuses with MCA\u2010PSV &gt; 1.5 MoM prior to intrauterine transfusion (IUT) had severe fetal anemia on FBS. In fetuses with severe anemia on the first FBS, the MCA\u2010PSV values 7 days before the first FBS were &lt; 1.29 MoM (four cases), between 1.29 and 1.5 MoM (two cases) and &gt; 1.55 MoM (one case).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In the management of Kell isoimmunization invasive procedures may be avoided by implementing MCA\u2010PSV measurements. Delineation of appropriate intervals between reassessments, the reliability of MCA\u2010PSV following repeated IUTs, and cut\u2010off values for FBS await further study. Copyright \u00a9 2006 ISUOG. 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