Comparison of two quantitative methods of microscopic feto-maternal haemorrhage evaluation

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Comparison of two quantitative methods of microscopic feto-maternal haemorrhage evaluation

Journal Title: Postępy Nauk Medycznych - Year 2012, Vol 25, Issue 7

Abstract

&lt;b&gt;Introduction.&lt;/b&gt; Quantification of feto-maternal haemorrhage (FMH) is essential for determination of an accurate dose of anti-RhD Ig in immunoprophylaxis of haemolytic disease of foetus and newborn in RhD negative mothers. The Kleihauer-Betke (K-B) test is one of some methods introduced to our laboratory for FMH investigation. In some countries it has been used routinely for many years, but in Poland only occasionally. K-B test is based on the different properties of haemoglobin F (HbF) in fetal red blood cells (RBCs) and haemoglobin A (HbA) in maternal RBCs. HbF is more resistant than HbA to both alkali denaturation and acid elution.&lt;br&gt;&lt;b&gt;Material and methods.&lt;/b&gt; Dried and stained blood films were examined using two quantitative methods: in the 1&lt;sup&gt;st&lt;/sup&gt; of them we counted twice (2 slides) foetal RBCs between 1000 maternal &amp;ldquo;ghost&amp;rdquo; cells, in the 2&lt;sup&gt;nd&lt;/sup&gt; we evaluated at least 10 000 cells, using a Miller square. These methods were performed 10 times for each prepared mixtures with 0.1%, 0.25%, 0.5%, 1% and 2% of foetal RBCs in adult blood, imitating FMH.&lt;br&gt;&lt;b&gt;Results.&lt;/b&gt; Coefficients of variation (CV) were appropriate in the 2&lt;sup&gt;nd &lt;/sup&gt;method (&amp;lt; 20%) and estimated volumes of FMH were accurate. These values were not proper using the 1&lt;sup&gt;st&lt;/sup&gt; method (CV about 30% to 64%).&lt;br&gt;&lt;b&gt;Conclusions. &lt;/b&gt;K-B test can be the sensitive method for quantification of FMH if we assess at least 10 000 RBCs.

Authors and Affiliations

Agata Gieleżyńska, Jadwiga Fabijańska-Mitek

Keywords

feto-maternal haemorrhage Kleihauer-Betke test immunoglobulin anti-RhD haemolytic disease of foetus/newborn przeciek płodowo-matczyny test Kleihauera-Betke immunoglobulina anty-RhD choroba hemolityczna płodu/noworodka

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EP ID EP54487
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