Assessment of feto-maternal hemorrhage among rhesus D negative pregnant mothers using the kleihauer-betke test (KBT) and flow cytometry (FCM) in Addis Ababa, Ethiopia.
BACKGROUND
This study aimed to assess fetomaternal hemorrhage (FMH) among RhD negative pregnant mothers using two techniques, Kleihauer-Betke (KBT) and Flow cytometry (FCM). To determine if patient-specific doses of prophylactic anti-D warrant further investigation in Ethiopia and wider Africa.


METHODS
Hospital- based cross-sectional study was conducted among 75 RhD negative pregnant mothers using convenient sampling technique.


RESULTS
FMH has been detected in 52% and 60% by KBT and FCM techniques, respectively. The volume of FMH quantified in the majority of the cases (92.5% and 87%) was <10 mL fetal blood while >30 mL in 1.3% (1/75) and 2.7% (2/75) as calculated by KBT and FCM, respectively. The FMH calculated by the two methods have good correlation; r = 0.828 (p = 0.000) for categorized and r = 0.897 (p = 0.000) for continuous values and the agreement between the FCM and KBT was moderate with kappa (κ) value of 0.53 (p = 0.000).


CONCLUSIONS
Most of FMH calculated (<10 mL) could have been neutralized by lower doses which might have lower costs than administering 300 μg dose which is currently in practice in our country for affording mothers. Besides, it also showed that the volume of FMH was >30 mL in 1.3% and 2.7% of the cases as calculated by KBT and FCM, respectively, which need more than 300 μg dose RhIG for neutralization. Further investigation into the cost- effectiveness and scalability of patient- specific dosing of prophylactic anti-D appears warranted.
Department of Medical Laboratory Science, Haramaya University, Harar, Ethiopia. urgessafekadu@gmail.com.
Fekadu
F
Urgessa
Aster
A
Tsegaye
Yirgu
Y
Gebrehiwot
Asaye
A
Birhanu
D000293:Adolescent; D000328:Adult; D015193:Chorionic Villi Sampling / Q000379:methods*; D003430:Cross-Sectional Studies; D003906:Developing Countries; D005002:Ethiopia; D005260:Female; D005312:Fetal Blood / Q000276:immunology; D005331:Fetomaternal Transfusion / Q000175:diagnosis* / Q000276:immunology / Q000628:therapy; D005434:Flow Cytometry / Q000379:methods*; D006801:Humans; D007518:Isoantibodies / Q000008:administration & dosage* / Q000276:immunology; D011247:Pregnancy; D011250:Pregnancy Complications, Hematologic / Q000175:diagnosis* / Q000276:immunology; D011933:Reagent Kits, Diagnostic; D012204:Rh-Hr Blood-Group System / Q000276:immunology*; D018029:Rho(D) Immune Globulin; D012680:Sensitivity and Specificity; D055815:Young Adult
D007518:Isoantibodies; C061961:RHO(D) antibody; D011933:Reagent Kits, Diagnostic; D012204:Rh-Hr Blood-Group System; D018029:Rho(D) Immune Globulin