The Value of Kleihauer Test in the Detection of Fœtomaternal Transfusion in Iraqi Patients

Abstract

Back ground: Rh isoimmunization represents an important problem that contributes to fœtal morbidity resulting in hæmolytic disease of newborns (HDN) and abortions in successive pregnancies. The major treatment strategy relies upon prevention of sensitization by administration of Anti-D immunoglobulin to Rh negative mothers giving birth to Rh positive babies within 72 hours after birth. This is usually controlled by counting the number of fœtal red cells in the maternal circulation by Kleihauer test which is routinely conducted to all Rh negative mothers.Objectives: This study is designed for detection of random cases of fœtomaternal transfusion during delivery in Iraqi patients irrespective of mother's Rh status, in order to understand fully the probability of isoimmunization after uneventful deliveries.Material and method: Blood samples were collected from mothers just delivered, immediately smeared making thin blood film and subjected to Kleihauer test.Results: Out of 86 maternal blood samples collected one hour after delivery, 25 (28.9%) cases revealed significant fœtomaternal transfusion, ranging from minor (1-3 ml) transfusion representing 16 cases out of 86 (18.6%), moderate (4-10 ml) transfusion representing 4 cases (4.6%) and major (>10 ml) transfusion representing 5 cases (5.8%). Massive fœtomaternal transfusion (>30 ml) was not detected in all cases.Conclusions: Fœtomaternal transfusion with different degrees is a frequent event during IU Anti-D immunoglobulin 72 hours after birth is adequate in elimination of almost all fœtal red cells in Rh negative mothers giving birth to Rh positive babies.