Detection of fetomaternal hemorrhage.

摘要: The prevention of Rhesus D alloimmunization through Rh immune globulin (RhIg) administration is the major indication for accurate detection and quantification fetomaternal hemorrhage (FMH). In setting incompatibility, D-positive fetal cells can sensitize D-negative mother, resulting in maternal anti-D alloantibody production. These alloantibodies may lead to undesirable sequelae such as hemolytic disease newborn (HDN). Since widespread adoption FMH screening RhIg immunoprophylaxis, overall risk infant mortality from HDN has substantially decreased. rosette screen, initial test choice, highly sensitive qualitatively detecting 10 mL whole blood circulation. As screen reliant on presence antigen distinguish cells, it cannot be used detect mothers or carrying a fetus. Kleihauer-Betke acid-elution test, most widely confirmatory quantifying FMH, relies principle that RBCs contain mostly hemoglobin (HbF), which resistant whereas adult acid-sensitive. Although inexpensive requires no special equipment, lacks standardization precision, not conditions with elevated F-cells. Anti-HbF flow cytometry promising alternative, although its use limited by equipment staffing costs. Hematology analyzers capabilities adapted cell detection, thus giving clinical laboratories potentially attractive automated alternative FMH.