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Fetal maternal testing on rh positive pt?


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This may be a silly question but I have a doctor wanting to check for FMH on an O Positive mother. Obviously the fetal screen would be invalid but what about kleihauer-betke? I know this will actually show if there are fetal cells circulating but the baby is also O Positive so wouldn't this be moot? Plus she wouldn't need RhIG.....please help?

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Feel proud of your very public admission of posting before thinking things through fully - I would argue against your use of the word 'stupidity by the way.

In my lab in a district hospital with a busy maternity department, we would routinely do a kleihauer test (whether requested or not but we didn't have billing issues to contend with) on any maternal sample where a diagnosis of IUD was given or implied (ie where the baby had died in late pregnancy)whatever the blood group of the mother. This was frequently useful in showing or excluding a large foetal bleed and was appreciated by the coroner who was later trying to determine the cause of death. Although not a documented or (as far as I know) proven advantage of the kleihauer is that, in our experience, non-recent bleeds tend to be shown by the presence of heavily crenated foetal RBC, suggesting a prolonged, slow bleed rather than a sudden traumatic bleed.

I have never learned anything by being right (and I have frequently been oh so very wrong) so do, please, continue to make 'stupid' posts !

Edited by pstruik
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