Kleihauer-Betke (KB) Test. The KB test is performed to quantitate the number of fetal cells present in the maternal circulation. Once the size of the feto-maternal. Hemoglobin F quantitation by flow cytometry has been found to be simple, reliable, and more precise than the Kleihauer-Betke test,87 In the CAP. The Kleihauer-Betke test is a somewhat crude laboratory method used to screen maternal blood samples for the presence of fetal red blood cells.

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Clinical assessment does not. Standard Kleihauer-Betke testing in any experienced laboratory is sufficient. HgF, being resistant to the acid, removes intact, whereas HgA is removed. Trauma is the number one cause of pregnancy-associated maternal deaths in the United States Ref: By using this site, you agree to the Terms of Use and Privacy Policy.

In general this is not a problem. Unsourced material may be challenged and removed. TPH, defined as KB-positive for greater than 0.

Kleihauer–Betke test

Potential Diagnosis The Rosette test is a qualitative screening test performed on a maternal blood sample to determine if Bete has occurred between a Rh-positive fetus and a Rh-negative mother and serves as a useful screening test. Review Detection of fetomaternal hemorrhage. Kleihauer Betke test is utilized to determine if there is fetal blood in maternal circulation, with a threshold of 5 mL.

Blood drawing can be done pre- or postpartum at the convenience of the care provider and the mother; only if cesarean section is anticipated is it important to draw the sample prior bteke delivery. Kleihauer test, showing fetal red blood cells in rose-pink color, while adult red blood cells are only seen as “ghosts”. Apt—Downey test Kleihauer—Betke test.



In maternal trauma, the Kleihauer-Betke KB test has traditionally been used to detect transplacental hemorrhage TPHso that Rh-negative women could receive appropriate Rh immune prophylaxis. Since fetal and maternal blood cells have the same life expectancy in the maternal bloodstream, it is possible to obtain informative results from a KB stain for a fair period of time after a stillbirth.

Krywko ; Sara M. Once the size of the feto-maternal hemorrhage FMH is determined, the appropriate RhIG dose can be calculated and administered to prevent the mother from making anti-D.

No historical or clinical features reliably identify those in whom it may be the kleeihauer of an intrauterine death. The information gained is important because recurrence risks may be less than for unexplained stillbirth. However, there are times when the additional dose is necessary due to massive red blood cell FMH and subsequent maternal immune response. From Wikipedia, the free encyclopedia. Qualitative testing may be utilized prior to quantitative testing, i.

Kleihauer-Betke (KB) Test – , Laboratory Continuing Education

Ebtke Journal of Hematology. So, unless all stillbirths are tested, a large proportion of FMH will remain undetected. Reticulocyte index Haptoglobin Mentzer index. Stillbirth assessment should, in all instances, incorporate testing of maternal blood for evidence of massive fetal-maternal hemorrhage. Specimen Collection The specimen is collected from the maternal patient through peripheral venous phlebotomy. This is when the Kleihauer-Betke KB test is essential.

In 25 women with a negative KB test, none had uterine contractions. It is important to note, however, that such a diagnosis is still not completely conclusive; fetuses losing large quantities of blood over long periods of time are able to compensate for this slower blood loss; since the KB stain tells us nothing with regard to the level of acuity of FMH.


The blue arrows in the bottom image point to fetal cells that have taken up the stain. Epub Jan 9. Log In Sign up for our mailing list. Support Center Support Center. Their records were abstracted for demographics, injury type, three separate trauma scores, documented uterine contractions, PTL contractions with progressive cervical changeand serious perinatal complications.

Mean corpuscular hemoglobin Mean corpuscular hemoglobin concentration Mean corpuscular volume Red blood cell distribution width. Fetal tissue Chorionic villus sampling Amniocentesis Blood Triple test Quad test Percutaneous umbilical cord blood sampling Apt test Kleihauer—Betke test Tesr maturity Lecithin—sphingomyelin ratio Lamellar body count Fetal fibronectin test.

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Fetal cells remain intact because of high concentrations of HbF, while HbA is eluted from the maternal cells. In the case of massive trauma, the KB test may be utilized primarily, without the preliminary use of the screening Rosette test.

Interfering Factors In the case of maternal persistence of fetal hemoglobin or other maternal hemoglobinopathies that result in elevated HbF, the KB test will be falsely positive and flow cytometry must be used to quantitate the amount of fetal hemorrhage in maternal circulation.