Flow cytometry in diagnosis and management of large fetomaternal haemorrhage

Johnson, P.R., Tait, R.C. , Austin, E.B., Shwe, K.H. and Lee, D. (1995) Flow cytometry in diagnosis and management of large fetomaternal haemorrhage. Journal of Clinical Pathology, 48(11), pp. 1005-1008. (doi: 10.1136/jcp.48.11.1005) (PMID:8543620) (PMCID:PMC503003)

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AIMS--To evaluate an indirect immunofluorescence flow cytometry technique in a series of patients with large fetomaternal haemorrhage (FMH). METHODS--Patient samples identified by Kleihauer testing in local laboratories as having FMH > 4 ml were sent for flow cytometric analysis. In a proportion of cases the mothers received anti-D immunoglobulin prophylaxis according to the flow cytometer estimate of FMH volume. RESULTS--Forty three cases of FMH were studied prospectively. The correlation between Kleihauer and flow cytometry results was poor. In 38 (88%) cases the size of FMH quantitated by flow cytometry was lower than that estimated using the Kleihauer technique. In 13 (30%) cases no Rh D immunoglobulin positive cells were detected by flow cytometry. Centralised review of the original Kleihauer films using a calibrated microscope resulted in improved, but still suboptimal correlation with flow cytometry results. In 15 cases anti-D immunoglobulin was given according to the flow cytometer estimation of FMH size, resulting in a 58% reduction in the amount of anti-D immunoglobulin given. None of the patients were immunised when tested six months later. CONCLUSIONS--Flow cytometry is helpful for the accurate quantitation and management of patients with large FMH and in cases where the presence of maternal haemoglobin F containing cells renders the Kleihauer technique inaccurate. Worthwhile reductions in the use of anti-D immunoglobulin can be achieved.

Item Type:Articles
Glasgow Author(s) Enlighten ID:Tait, Dr Robert
Authors: Johnson, P.R., Tait, R.C., Austin, E.B., Shwe, K.H., and Lee, D.
College/School:College of Medical Veterinary and Life Sciences > School of Cardiovascular & Metabolic Health
Journal Name:Journal of Clinical Pathology
Publisher:BMJ Publishing Group
ISSN (Online):1472-4146

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