Possibility to identify fetomaternal haemorrhage

Czech version

Authors: M. Studničková ¹; M. Lubušký ¹; M. Ordeltová ²; M. Procházka ¹
Authors‘ workplace: Porodnicko-gynekologická klinika FN, Olomouc, přednosta doc. MUDr. R. Pilka, Ph. D. ¹; Oddělení alergologie a klinické imunologie FN, Olomouc, přednosta doc. MUDr. J. Bystroň, CSc. ²
Published in: Ceska Gynekol 2010; 75(5): 443-446

Overview

Fetomaternal haemorrhage (FMH) is a status characterised by penetration of fetal blood into the maternal circulation which happens mostly at delivery. FMH may cause erythrocytal alloimmunisation of woman. That is why anti-D immunoglobulin (IgG anti-D) is being administered to RhD negative women after delivery of RhD positive fetus. IgG anti-D is administered to RhD negative women standardly and in much greater quantities than is actually necessary. However, on the other hand, it is not possible to diagnose cases where a greater dose is required. To optimalise prevention of RhD alloimmunization in RhD negative women, it is important to diagnose conditions where fetomaternal haemorrhage (FMH) occurs, precisely define its volume and consequently administer the required dose of IgG anti-D. The ability to reliably detect fetomaternal haemorrhage (FMH) and precisely define its volume would allow better and less expensive prevention of RhD alloimmunization in RhD negative women. IgG anti-D could thus be administered only in cases that are actually indicated and only in doses necessary for preventing RhD alloimmunization. Accurate quantification of FMH is determined by flow cytometry.

Design:
Review.

Setting:
Department of Obstetrics and Gynecology, Department of Alergology and Clinical Immunology, University Hospital Olomouc.

Key words:
fetomaternal haemorrhage, flow cytometry, Kleihauer-Betke test, anti-D immunoglobulin, RhD alloimmunisation.

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