| Laboratory methods for Rh immunoprophylaxis: a review. | |
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MedLine Citation:
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PMID: 21214295 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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S G Sandler; S Sathiyamoorthy |
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Publication Detail:
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Type: Journal Article; Review |
Journal Detail:
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Title: Immunohematology / American Red Cross Volume: 26 ISSN: 1930-3955 ISO Abbreviation: Immunohematology Publication Date: 2010 |
Date Detail:
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Created Date: 2011-01-10 Completed Date: 2011-07-18 Revised Date: 2012-03-30 |
Medline Journal Info:
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Nlm Unique ID: 8806387 Medline TA: Immunohematology Country: United States |
Other Details:
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Languages: eng Pagination: 92-103 Citation Subset: IM |
Affiliation:
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Georgetown University Hospital, Room M1306, Department of Laboratory Medicine, 3800 Reservoir Road, NW, Washington, DC 20007, USA. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Erythroblastosis, Fetal
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immunology,
prevention & control* Female Flow Cytometry / methods* Humans Rh Isoimmunization / diagnosis, immunology, prevention & control* Rh-Hr Blood-Group System / immunology* Rho(D) Immune Globulin / therapeutic use* Sensitivity and Specificity |
| Chemical | |
Reg. No./Substance:
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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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