title: Comparison of estimation of volume of fetomaternal hemorrhage using Kleihauer-Betke test and microcolumn gel method in D-negative nonisoimmunized mothers.
abstract: In this study we assessed the efficay of the microcolumn gel method in the detection and quantification of the volume of fetomaternal hemorrhage (FMH) in comparison with the Kleihauer-Betke test (KB) in nonisoimmunized D- mothers. We collected blood samples from 80 D- indirect antiglobulin test-negative mothers over a span of more than 1 year. FMH was determined by KB and microcolumn gel method, and the results were compared. FMH was recorded as less than 4 mL by KB if no fetal cells were seen after examining 25 fields using 10x objective. If fetal cells were seen, slides were examined furhter to quantify FMH. By microcolumn gel method, FMH was reported as less than 0.1 percent, 0.1 percent, 0.2 percent, and 0.4 percent or greater. None of the patients had FMH greater than 15 mL by KB . Sixty-two patients (77.5%) had FMH less than 4mL by KB. In all these cases , FMH was less than or equal 0.2 percent (approximately 4mL) by microcolumn gel method. The mean volume of FMH in the remaining 18 (22.5%) cases by KB was 8.3 ± 1.7 mL. Fifteen (83.3%) of these 18 cases had FMH of at least 0.4 percent (approximately 8 mL) by gel technology. Three cases (16.7%) that differed from KB results had FMH of 0.2 percent by microcolumn gel method with a maximal FMH of 6.4 mL by KB. FMH was significanlty increased in cesarean delivery (mean FMH 9.5 ± 0.8 mL, range 7.9-10.4 mL, p=0.001) abd abtepartum hemorrahge (mean FMH 9.5 ± 0.9 mL, range 7.9-10.4 mL, p< 0.001). Microcolumn gel method is an effective screening test . Technologies like KB and flow cytometry are better options for detecting a large volume of FMh. Antepartum hemorrhage and cesarean delivery are risk factors for FMH. the 300-µg dose of cases. We need to analyze the relative cost-effectiveness of universal administration of 300µg of Rh immune globulin vs. FMH quantitation with subsequent administration of titrated doses.
authors: MD (corresponding author), Senior Resident.
authors: K
authors: K
authors: Mittal
authors: N
authors: N
authors: Marwaha
authors: P
authors: P
authors: Kumar
authors: S C
authors: SC
authors: Saha
authors: B
authors: B
authors: Thakral
mesh_terms: D000328:Adult; D004912:Erythrocytes / Q000276:immunology / Q000473:pathology*; D005260:Female; D005331:Fetomaternal Transfusion / Q000097:blood / Q000175:diagnosis*; D005333:Fetus; D006403:Hematologic Tests / Q000295:instrumentation / Q000379:methods / Q000592:standards*; D006801:Humans; D011247:Pregnancy; D012203:Rh Isoimmunization / Q000517:prevention & control; D012204:Rh-Hr Blood-Group System / Q000097:blood* / Q000276:immunology
chemical_list: D012204:Rh-Hr Blood-Group System