In this article:
We spoke to Dr Siddhi Shree Dixit, Consultant – Fetal Medicine, Madhukar Rainbow Children’s Hospital, to understand what foetal anaemia is, how it is detected before birth, and what parents should know about its management.
What Is Foetal Anaemia?
Foetal anaemia means your baby has fewer red blood cells or less haemoglobin than expected before birth.“Low haemoglobin levels in the baby can lead to reduced oxygen delivery to various organs, causing overload on the heart and fluid collection in various parts of the baby, known as hydrops.”
- Dr Siddhi Shree Dixit, Consultant – Fetal Medicine, Madhukar Rainbow Children’s Hospital
What Can Cause Foetal Anaemia?
Foetal anaemia can develop for different reasons. A common cause is maternal antibodies attacking the baby’s red blood cells due to certain blood-group differences, including Rh incompatibility.Other causes include:
- Parvovirus B19 infection, which can affect red blood cell production.
- Foetomaternal haemorrhage, when the baby loses blood into the mother’s circulation.
- Twin-to-twin transfusion syndrome in some twin pregnancies.
- Certain inherited blood conditions.
- Some infections or problems involving the placenta.
How Is Foetal Anaemia Detected Before Birth?
Foetal anaemia may not cause any symptoms in the mother, so doctors use different tests to check the baby’s health when there is a concern.Diagnosis may include:
1. Maternal Blood Tests
Blood tests can check for antibodies that may attack the baby’s red blood cells. If these antibodies are present, your doctor may recommend closer monitoring.2. Ultrasound Scan
Ultrasound helps doctors check your baby’s growth, fluid levels and overall wellbeing. In severe anaemia, signs may include excess fluid or an enlarged heart.3. Middle Cerebral Artery Doppler
An MCA Doppler is a specialised ultrasound that measures blood flow through an artery in your baby’s brain. Faster-than-expected blood flow can be a sign of anaemia. Doctors compare the measurement with the baby’s gestational age to decide whether further monitoring or testing is needed.The test is non-invasive and does not involve inserting a needle into the womb.
Who May Need Closer Monitoring?
Not every pregnancy needs specialised testing for foetal anaemia.Your doctor may recommend additional monitoring if there is a known risk, such as:
- Significant maternal blood-group antibodies
- A previous pregnancy affected by severe anaemia or haemolytic disease
- Suspected parvovirus B19 infection
- A pregnancy involving certain complications in twins
- Suspected bleeding between the baby and mother
- Ultrasound findings that raise concern about the baby’s condition
What Happens If Foetal Anaemia Is Suspected?
If your baby may have foetal anaemia, your doctor may:- Repeat ultrasound and Doppler scans to closely monitor your baby.
- Perform foetal blood sampling if needed to assess the severity of the anaemia.
- Give an intrauterine blood transfusion through the umbilical cord if the anaemia is severe.
- Plan delivery when your baby is ready or if continuing the pregnancy becomes unsafe.
Can Foetal Anaemia Be Prevented?
Some causes can be prevented or reduced. For example, Rh immunoglobulin (anti-D) can help prevent Rh-negative mothers from developing antibodies that could affect a future Rh-positive pregnancy.Keeping up with recommended antenatal blood tests is therefore important. These routine checks can identify blood-group antibodies and other concerns before they cause serious complications.
When Should You Speak to Your Doctor?
Speak to your doctor if:- Blood tests show blood-group antibodies.
- You have been exposed to parvovirus B19.
- An ultrasound shows something unusual.
- Your doctor says your baby may be at higher risk of anaemia.
- You are advised to see a foetal medicine specialist for closer monitoring.
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FAQs on What Is Foetal Anaemia and How Is It Detected Before Birth?
- Can blood-group problems increase the baby’s risk?
Yes. Certain blood-group antibodies in the mother can cross the placenta and affect the baby’s red blood cells, increasing the risk of anaemia. - Is foetal anaemia more common in twin pregnancies?
Certain twin complications, such as twin-to-twin transfusion syndrome, can increase the risk. Doctors may therefore recommend closer monitoring in affected twin pregnancies. - What does an abnormal MCA Doppler mean?
A higher-than-expected blood-flow speed may suggest anaemia. Your doctor will interpret the result according to your baby’s gestational age and overall condition.