[Evaluation of fetomaternal hemorrhage in postpartum patients with indication for administration of anti-D immunoglobulin]
Author(s): Baiochi E, Camano L, Bordin JO
Affiliation(s): Departamento de Obstetricia, Escola Paulista de Medicina, Universidade Federal de Sao Paulo, Sao Paulo, Brazil. email@example.com
Publication date & source: 2005-09, Cad Saude Publica., 21(5):1357-65. Epub 2005 Sep 12.
This study evaluated fetomaternal hemorrhage (FMH) in 343 postpartum patients who required prophylaxis of Rh alloimmunization with anti-D immunoglobulin. The rosette test was applied to screen for patients needing quantitative determination of fetal blood transferred from the maternal circulation, which was then measured by the Kleihauer-Betke test (K-B). The rosette test was positive in 22 cases (6.4%). In five of these cases, K-B did not show fetomaternal hemorrhage (a 1.45% false-positive rate for the rosette test), and in one case the test was inconclusive. There were 8 cases with FMH < 10 ml (2.3%), 6 cases with FMH from 10 to 30 ml (1.7%), and two cases with FMH > 30 ml (0.58%), requiring a supplementary dose of anti-D. The study concludes that following the rosette test, additional evaluation of FMH using a quantitative test was unnecessary in 93.6% of the cases.