Document Detail

Laboratory methods for Rh immunoprophylaxis: a review.
MedLine Citation:
PMID:  21214295     Owner:  NLM     Status:  MEDLINE    
The recommended dose of Rh immune globulin for postpartum Rh immunoprophylaxis is based on an estimation of the volume of the fetomaternal hemorrhage, if any, measured as the percent of fetal RBCs in a sample of the D– mother's blood. Laboratory methods for distinguishing fetal from maternal RBCs have been based on their different blood types (D+ versus D–) or predominant hemoglobin content (hemoglobin F versus hemoglobin A). We conducted a review of the medical literature describing laboratory methods for detecting and quantifying fetal RBCs in maternal blood samples. We also used data collected for the College of American Pathologists Fetal RBC Detection Surveys to determine which laboratory methods are used currently in hospitals in the United States. The rosette screen is used widely for identifying D– mothers who may require additional doses of Rh immune globulin for postpartum immunoprophylaxis. As the rosette screen targets the D antigen, it is not suitable for detecting a fetomaternal hemorrhage in D+ mothers or when the D type of the fetus or newborn is D– or unknown. The acid-elution (Kleihauer- Betke) assay is a sensitive laboratory method for quantifying a fetomaternal hemorrhage, but it is tedious, often inaccurate, and difficult to reproduce. Flow cytometry, using anti-D or anti-hemoglobin F reagents, offers a more precise quantification of fetal RBCs in maternal blood. However, flow cytometry services for this function are available in relatively few hospital laboratories in the United States because of logistic and fiscal impediments.
S G Sandler; S Sathiyamoorthy
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Immunohematology / American Red Cross     Volume:  26     ISSN:  1930-3955     ISO Abbreviation:  Immunohematology     Publication Date:  2010  
Date Detail:
Created Date:  2011-01-10     Completed Date:  2011-07-18     Revised Date:  2012-03-30    
Medline Journal Info:
Nlm Unique ID:  8806387     Medline TA:  Immunohematology     Country:  United States    
Other Details:
Languages:  eng     Pagination:  92-103     Citation Subset:  IM    
Georgetown University Hospital, Room M1306, Department of Laboratory Medicine, 3800 Reservoir Road, NW, Washington, DC 20007, USA.
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MeSH Terms
Erythroblastosis, Fetal / immunology,  prevention & control*
Flow Cytometry / methods*
Rh Isoimmunization / diagnosis,  immunology,  prevention & control*
Rh-Hr Blood-Group System / immunology*
Rho(D) Immune Globulin / therapeutic use*
Sensitivity and Specificity
Reg. No./Substance:
0/Rh-Hr Blood-Group System; 0/Rho(D) Immune Globulin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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