Assessment of fetomaternal hemorrhage by flow cytometry and Kleihauer-Betke test in Rh-negative pregnancies

Gynecol Obstet Invest. 2008;65(2):84-8. doi: 10.1159/000108401. Epub 2007 Sep 18.

Abstract

Objectives: To assess the efficacy of flow cytometry (FC) in the detection and quantification of fetomaternal hemorrhage (FMH) in comparison to the Kleihauer-Betke test (KBT).

Methods: 25 unsensitized Rh-negative mothers who had delivered Rh-positive infants were included. Presence of FMH was determined by KBT and FC using FITC-labeled BRAD-3 antibodies.

Results: FMH was detected in 19 (76%) patients by FC and 23 (92%) patients by KBT prior to delivery, and in 21 (84%) patients by FC and 23 (92%) patients by KBT after delivery. The mean volume of FMH in the post-delivery samples by KBT and FC were 0.34 +/- 0.26 ml (range 0.05-1.2 ml) and 0.37 +/- 0.57 ml (range 0.02-2.6 ml) respectively. The volume of post-delivery FMH estimated by KBT and FC correlated well (r = 0.75; ICC alpha = 0.73). A higher agreement between KBT and FC was seen in the 0.1-0.5 ml range (kappa = 0.65; p < 0.01).

Conclusions: Both manual KBT and FC using FITC-BRAD-3 antibodies show good sensitivity in detecting and quantifying fetal red cells. There is a good correlation between the methods in the 0.1- to 0.5-ml range of FMH.

MeSH terms

  • Adult
  • Antibodies, Monoclonal*
  • Female
  • Fetomaternal Transfusion / blood
  • Fetomaternal Transfusion / diagnosis*
  • Flow Cytometry / methods*
  • Gestational Age
  • Humans
  • Infant, Newborn
  • Postpartum Period
  • Predictive Value of Tests
  • Pregnancy
  • Prenatal Diagnosis
  • Rh-Hr Blood-Group System / immunology*
  • Sensitivity and Specificity

Substances

  • Antibodies, Monoclonal
  • Rh-Hr Blood-Group System