A modified Kleihauer technique for the quantification of foetomaternal haemorrhage

• Published in: Transfusion medicine (Oxford, England) England), 2002-12, Vol.12 (6), p.373-378
• Main Authors: Howarth, D. J., Robinson, F. M., Williams, M., Norfolk, D. R.
• Format: Article
• Language: English
• Subjects: Clinical Laboratory Techniques - standards; Erythrocyte Count; Female; Fetomaternal Transfusion - diagnosis; Flow Cytometry; foetomaternal haemorrhage; Humans; Kleihauer technique; maternal ghost cells; Observer Variation; Pregnancy; Reproducibility of Results; Staining and Labeling - methods
• ISSN: 0958-7578; 1365-3148
• DOI: 10.1046/j.1365-3148.2002.00406.x

Summary The Kleihauer technique, based on acid elution of maternal red cells, is the mostly widely used technique in the UK to screen for, and estimate the volume of, foetomaternal haemorrhage (FMH) and for determining the need for additional doses of anti‐D immunoglobulin to prevent maternal alloimmunization. However, technicians often report difficulties in identifying and accurately counting maternal red cells in the blood film, leading to imprecision in the calculated FMH. In this report, we describe a simple modification of the standard Kleihauer technique, based on performing acid elution of only half of the film. Compared to the standard method, the modified technique showed improved accuracy and reduced interobserver varability across a range of simulated FMH volumes. There was a high degree of correlation between the new technique and FMH estimated by flow cytometry (r2 = 0·916, P