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Quantification of feto-maternal hemorrhage: selection of techniques for a resource-poor setting.
MedLine Citation:
PMID:  21160194     Owner:  NLM     Status:  In-Process    
Abstract/OtherAbstract:
BACKGROUND: Though RhD sensitization in RhD-negative mothers is now almost eradicated in the developed world, it continues to be a major health problem in developing nations like India. Inadequate immunoprophylaxis is the main reason. Adequate dose calculation of anti-D Ig is possible through estimation of correct feto-maternal hemorrhage (FMH) volume. In this regard, different methods have been used.
METHODS: We evaluated three quantitative techniques of estimating FMH: the Kleihauer-Betke test (KBT) and two flow cytometry (FC) techniques, i.e., the indirect immunofluorescence technique (IIFT) and direct immunofluorescence technique (DIFT). Stock solutions of both RhD-positive and D-negative cells were made, and 7 serial dilutions of RhD-positive cord cells in D-negative adult cells were prepared.
RESULT: Both KBT and FC approximated the expected concentration of fetal RhD-positive cells in all mixtures tested. In both methods, an underestimation of fetal RhD-positive cells was observed when their expected concentration was ≥0.75%.
CONCLUSION: Though FC is the most sensitive of all techniques, very few laboratories in developing nations can afford such a costly device, so it will be prudent for them to use KBT as the gold standard due to its rapidity, simplicity and affordability.
Authors:
Prashant Agarwal; Sudipta Sekhar Das; Ritu Gupta; Dheeraj Khetan; Rajendra Chaudhary
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Publication Detail:
Type:  Journal Article     Date:  2010-12-15
Journal Detail:
Title:  Gynecologic and obstetric investigation     Volume:  71     ISSN:  1423-002X     ISO Abbreviation:  Gynecol. Obstet. Invest.     Publication Date:  2011  
Date Detail:
Created Date:  2011-01-13     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7900587     Medline TA:  Gynecol Obstet Invest     Country:  Switzerland    
Other Details:
Languages:  eng     Pagination:  47-52     Citation Subset:  IM    
Copyright Information:
Copyright © 2010 S. Karger AG, Basel.
Affiliation:
Department of Transfusion Medicine, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India. prashant@sgpgi.ac.in
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