Assessment of Fetomaternal Hemorrhage in Rhesus D-negative Postpartum Women by Kleihauer—Betke Test

Abstract

Objectives:The aim of this article is to assess fetomaternal hemorrhage (FMH) and determine its volume and also to study the relation of the amount of FMH to various factors. Materials and methods:This was a prospective study carried out at Ahmedabad Civil Hospital from October 2012 to March 2013. A total of 75 blood samples were collected from RhDnegative mothers during the postnatal period. Sixteen samples were excluded because the fetus blood group was either Rh negative or unknown. The acid elution or Kleihauer-Betke quantitative test was used to measure the amount of FMH. The data were analyzed using Epi Info version 7.Results: With Kleihauer-Betke/acid elution test (KBT), 45.76% of women had fetal whole blood in their blood circulation during a postnatal period varying from 1.2 to 9.6 mL. The test was negative (i.e., no fetal cells were identified) in 54.24% of women. The majority of women had hemorrhage less than 4 mL. None of them had a large FMH. Conclusion:Most of the FMH calculated was <10 mL, which could have been neutralized by lower doses of anti-D immunoglobulin, which have incurred lower costs than the 300-µg dosage. Thus, developing optimized testing and accessing dosing protocols is needed in health care facilities. In the present study, we found no significant relation between the amount of FMH and parity or type of delivery.