PTD - 37

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Test Directory - Kleihauer (Cord / Maternal Testing)

Synonyms

Clinical Indications

To determine the presence of foetal cells in maternal circulation.

Request Form

Combined Pathology Blood form (Yellow/Black or Blue for GP's)

Availability

Performed daily

Specific Criteria

Mother must be Rh negative and / or have suffered an injury likely to cause foetal / maternal haemorrhage.

Turnaround Time

Within 72 hours.

Specimen

Whole Blood (Maternal and Cord samples) Cord blood when available (post partum)

Volume

1x 6ml - Maternal.
1x 6ml - Cord (if post partum)

Container

Purple top (EDTA) tubes. 1x Maternal blood and 1x Cord blood.

Collection

Cord samples must be collected immediately post partum and mother's samples should be collected a minimum of 1 hour post delivery to allow full circulation of any foetal blood.

Lab. Handling

Causes for Rejection

Unlabelled or incorrectly labelled or insufficient patient identifiers sample. Not meeting specific criteria for analysis. Delay in sample reaching laboratory.  Insufficient sample volume. Poor sample quality due to deterioration, haemolysis, presence of clot or either sample missing.

Limitations

 

False negatives due to lack of full circulation of foetal cells in the mother.

Interpretation

This is a screening test used to determine the number of foetal cells present in maternal circulation. A count of less than 10 cells per low power microscope field is indicated to be normal and a single dose of Anti D       (given to a mother with a Rh positive child) is sufficient to destroy the circulating foetal cells. A single dose is 1500 I.U. of Anti D Gamma Globulin, this should cover any unexpected bleeds and any incidences where placenta integrity could be damaged. A dose of 1500 i.u. is issued to RhD Negative women who give birth to RhD Positive babies. Any positive screens on RhD Negative mothers are sent for confirmation to the NHSBT for confirmation and to assess if subsequent doses of anti D Gamma Globulin are needed.
This test may also be used in cases of abdominal trauma during pregnancy, when a foetal bleed may be suspected. In such cases, if anti-D is required, the dosage is 500 i.u. if less than 20 weeks gestation or 1500 i.u. if greater than 20 weeks gestation.

        

 


Version 1.2 / May 2015