Immune sensitization is a dreaded consequence of fetal maternal hemorrhage in a Rhesus (Rh) negative woman pregnant with Rh positive fetus. Appropriate intrapartum and postpartum administration of Rh immune globulin to prevent such immune sensitization, relies on sensitive detection and accurate quantitation of fetomaternal hemorrhage.
Limitations in the sensitivity, precision and the difficulty in standardization of the manual Kleihauer-Betke test have prompted an increase utilization of flow cytometry for fetal cell detection in maternal blood samples.. Flow cytometry offers a simpler, more reliable and precise alternative to the Kleihauer-Betke technique, especially in massive feto-maternal hemorrhage. Flow cytometry aids in accurate quantitation and worthwhile reductions in the clinical use of anti-D immunoglobulin.
It should be noted that a well-performed Kleihauer-Betke test still appears useful as a screening technique for detection of feto-maternal hemorrhage. However, accurate quantitation of size of feto-maternal hemorrhage is more reliably determined by flow cytometry.
Flow cytometry has additional potential application for the study of HbF levels or frequency of adult red cells with low levels of HbF in individuals with hemoglobinopathies, and the medical evaluation of anemic patients, including sickle cell and thalassemic patients.(15.)
