KLEIHAUER BETKE TEST PDF

Kleihauer-Betke (KB) Test. The KB test is performed to quantitate the number of fetal cells present in the maternal circulation. Once the size of the feto-maternal. Hemoglobin F quantitation by flow cytometry has been found to be simple, reliable, and more precise than the Kleihauer-Betke test,87 In the CAP. The Kleihauer-Betke test is a somewhat crude laboratory method used to screen maternal blood samples for the presence of fetal red blood cells.

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Krywko ; Sara M. Krywko 1 ; Sara M. This disruption in the placental barrier may occur for many reasons, including intra-uterine fetal demise and trauma. Trauma is the number one cause of pregnancy-associated maternal deaths in the United States Ref: In response to this exposure, the maternal immune system is activated, and isoimmunization formation of Anti-RhD antibodies may occur if the mother is Rhesus-D protein RhD negative and the blood type of the fetus is RhD positive.

It takes only 0. Future pregnancies may be at risk for RhD disease if the fetus is RhD positive.

This dose will suppress the immune kleihauee to 2. After weeks gestational age, a dose of mcg is recommended. However, there are times when the additional dose is necessary due to massive red blood cell FMH and subsequent maternal immune response. This is when the Kleihauer-Betke KB test is essential. See Potential Diagnosis section for preliminary Rosette testing. It was further determined that, when immersed in a citrate buffer pH of 3.

The KB test is an acid-elution assay performed on maternal blood to determine the amount of HgF that has passed into maternal circulation. The process kleihsuer maternal blood smear to an acid solution. HgF, being resistant to the acid, removes intact, whereas HgA is removed. A total of cells is counted.

Kleihauer-betke testing is important in all cases of maternal trauma.

Calculation of the percentage of fetal vs. KB testing has obstetrical implications in diagnosis kleiihauer prognosis of preterm labor, fetal demise, and other conditions. There is some controversy on KB testing in the setting of trauma in pregnancy.

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This test has been historically only recommended for the Rh-negative pregnant patient with major trauma. Intuitively, however, the risk of FMH would increase with higher magnitude blunt force, anterior placental location, and coagulopathies among other factors. Some advocate its use in all pregnant trauma patients, including those who are RhD negative. It has been shown that a positive KB test accurately predicts the risk of preterm labor following trauma, whereas clinical assessment does not Ref: Because this is an independent risk factor, many authors recommended routine use in the setting of trauma, regardless of Rh status and regardless of the mechanism kleihaur force of the trauma.

The result then is used to guide management and education on prognosis. The Rosette test is a qualitative screening test performed on a maternal blood sample to determine if FMH has occurred betje a Rh-positive fetus and a Rh-negative mother and serves as a useful screening test.

Qualitative testing may be utilized prior to quantitative testing, i. In the case of massive trauma, the KB test may be utilized primarily, without the preliminary use of the screening Rosette test. The Rosette test is performed by incubating Rh negative maternal venous whole blood sample with anti-Rho D immune globulin.

During this incubation period, any Rh-positive fetal cells in the maternal sample are sensitized to the anti-Rho D immune globulin and bound.

Enzyme treated indicator cells are added, only binding to the fetal cells that were present and sensitized, resulting in a process called erythrocyte rosetting, or E-rosetting.

The indicator cells will be at the center of the rosette, while the fetal RBCs will be clustered around the edges, like petals on a flower. This rosetting pattern may then be viewed under microscopy.

Kleihauer Betke test is utilized to determine if there is fetal blood in maternal circulation, with a threshold of 5 mL. In the case of maternal persistence of fetal hemoglobin or other maternal hemoglobinopathies that result in elevated HbF, the KB test will be tesh positive and flow cytometry must be used to quantitate the amount of fetal hemorrhage in maternal circulation.

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Keep in mind that the amount of FMH to cause isoimmunization is only 0. If positive, it is used to determine additional RhoGAM dosing over the standard or mcg dosage that should be administered. To access free multiple choice questions on this topic, click here. This book is distributed under the terms of the Creative Commons Attribution 4. Turn befke back on. National Center for Biotechnology InformationU. StatPearls Publishing; Jan.

Show text Treasure Island FL: StatPearls Publishing ; Jan. Kleihauer Betke Test Diann M. Author Information Authors Diann M. Affilations 1 Medical University of South Carolina. Specimen Collection The specimen is collected from the maternal patient through peripheral venous phlebotomy. Indications KB testing has obstetrical implications in diagnosis and prognosis of preterm labor, fetal demise, and other conditions.

KLEIHAUER-BETKE TESTING

Potential Diagnosis The Rosette test is a qualitative screening test performed on a maternal blood sample to determine if FMH has occurred between a Rh-positive fetus and a Rh-negative mother and serves as a useful screening test. Interfering Factors In the case of maternal persistence of fetal hemoglobin or other maternal hemoglobinopathies that result in elevated HbF, the KB test will be falsely positive and flow cytometry must twst used to quantitate the amount of fetal hemorrhage in maternal circulation.

Volume of Fetal Blood: Questions To access free multiple choice questions on this topic, click here. Am J Public Health. PMC ] [ PubMed: Improvement of the Kleihauer-Betke test by automated detection of fetal erythrocytes in maternal blood. Cytometry B Clin Cytom. Persistent fetal hemoglobin in maternal circulation complicating the diagnosis of fetomaternal hemorrhage.

Kleihauer-betke testing is important in all cases of maternal trauma.

Similar articles in PubMed. Prevention of Rh alloimmunization. J Obstet Gynaecol Can. Guidelines for the Management of a Pregnant Trauma Patient.

Review Detection of fetomaternal hemorrhage. Epub Jan 9. Review [Prevention of fetomaternal rhesus-D allo-immunization.

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