MEASUREMENT OF FETOMATERNAL HEMORRHAGE - A COMPARATIVE-STUDY OF 3 KLEIHAUER TECHNIQUES AND 2 FLOW-CYTOMETRY METHODS

In the UK a Kleihauer test is routinely performed on all RhD-negative women after the birth of an RhD-positive child to ensure that an adequ ate dose of anti-D immunoglobulin is given, The results of Kleihauer t esting are interpreted to assess the volume of any fete-maternal haemo rrhage and additional anti-D immunoglobulin is administered if necessa ry. A similar procedure is followed ante-natally when incidents occur known to be associated with alloimmunization. The performance of Kleih auer tests is difficult to standardize and there can be problems in in terpreting the volume of fete-maternal haemorrhage. The use of now cyt ometry to measure fete-maternal haemorrhage is reported to give more a ccurate and reliable results. This study compared three different Klei hauer methods and two different flow cytometry techniques all performe d using the same maternal sample and within a single laboratory, The r esults demonstrated variability between the Kleihauer tests used and a lso in the flow cytometry measurements, A well-performed Kleihauer tes t would still appear to be useful as a screening technique for detecti on of fete-maternal haemorrhage. However, accurate quantitation of siz e of fete-maternal haemorrhage is more reliably determined by flow cyt ometry.