The incidences of positive Kleihauer-Betke test in low-risk pregnancies and maternal trauma patients.
OBJECTIVE
This study was undertaken to determine the incidence of positive Kleihauer-Betke (KB) tests in low-risk, third trimester patients and compare them with historical "control" patients who received KB tests for maternal trauma evaluations.


METHODS
Institution Review Board approval was obtained. KB tests were performed on 100 low-risk gravid women at the time of their routine glucose challenge tests after informed consent. All specimens were analyzed for fetal hemoglobin using the Clayton modification. Patients with identified risk factors for placental abruption were excluded. A retrospective chart review was performed on 583 historical control patients from 1998 to 2001 who had undergone maternal trauma evaluations, of which 151 had a KB test at comparable gestations. Demographic data from medical records were reviewed and compared. Data were analyzed with 2-sided Student t test, Mann-Whitney rank sum, and chi(2) tests, as indicated.


RESULTS
Of the low-risk women 5 of 98 (5.1%) had a positive KB test, whereas 4 of 151 (2.6%) trauma patients had a positive test (P=.31). None of these positive results were associated with a clinical abruption or fetal distress. One low-risk patient with sickle cell trait had a 40 mL KB result.


CONCLUSIONS
The incidence of a positive KB test in low-risk pregnancies does not differ from maternal trauma patients. Therefore, the presence of a positive KB test alone does not necessarily indicate pathologic fetal-maternal hemorrhage in patients with trauma.
Dhanraj
David
D
Department of Obstetrics and Gynecology, the E. Kenneth Hatton MD Institute for Research and Education of Good Samaritan Hospital, Cincinnati Ohio 45220, USA. ravraj@huno.com
Lambers
Donna
D
D000293:Adolescent; D000328:Adult; D016022:Case-Control Studies; D003955:Diagnostic Tests, Routine; D004906:Erythrocyte Count; D005260:Female; D005319:Fetal Hemoglobin / Q000032:analysis*; D005331:Fetomaternal Transfusion / Q000097:blood / Q000175:diagnosis*; D005865:Gestational Age; D006441:Hemoglobin A / Q000032:analysis; D006801:Humans; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis* / Q000209:etiology; D011256:Pregnancy Outcome; D011336:Probability; D012016:Reference Values; D012189:Retrospective Studies; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D018709:Statistics, Nonparametric; D014947:Wounds and Injuries / Q000150:complications*
D006441:Hemoglobin A; D005319:Fetal Hemoglobin