通过流式细胞术和克来豪尔-贝特克试验评估Rh阴性妊娠中的母胎输血情况。

Assessment of fetomaternal hemorrhage by flow cytometry and Kleihauer-Betke test in Rh-negative pregnancies.

作者信息

Savithrisowmya S, Singh Meenakshi, Kriplani Alka, Agarwal Nutan, Mehra N K, Bhatla Neerja

机构信息

Department of Obstetrics and Gynecology, All India Institute of Medical Sciences, New Delhi, India.

出版信息

Gynecol Obstet Invest. 2008;65(2):84-8. doi: 10.1159/000108401. Epub 2007 Sep 18.

DOI:10.1159/000108401

PMID:17878734

Abstract

OBJECTIVES

To assess the efficacy of flow cytometry (FC) in the detection and quantification of fetomaternal hemorrhage (FMH) in comparison to the Kleihauer-Betke test (KBT).

METHODS

25 unsensitized Rh-negative mothers who had delivered Rh-positive infants were included. Presence of FMH was determined by KBT and FC using FITC-labeled BRAD-3 antibodies.

RESULTS

FMH was detected in 19 (76%) patients by FC and 23 (92%) patients by KBT prior to delivery, and in 21 (84%) patients by FC and 23 (92%) patients by KBT after delivery. The mean volume of FMH in the post-delivery samples by KBT and FC were 0.34 +/- 0.26 ml (range 0.05-1.2 ml) and 0.37 +/- 0.57 ml (range 0.02-2.6 ml) respectively. The volume of post-delivery FMH estimated by KBT and FC correlated well (r = 0.75; ICC alpha = 0.73). A higher agreement between KBT and FC was seen in the 0.1-0.5 ml range (kappa = 0.65; p < 0.01).

CONCLUSIONS

Both manual KBT and FC using FITC-BRAD-3 antibodies show good sensitivity in detecting and quantifying fetal red cells. There is a good correlation between the methods in the 0.1- to 0.5-ml range of FMH.

摘要

目的

与克莱豪尔 - 贝特克试验（KBT）相比，评估流式细胞术（FC）在检测和定量母胎输血（FMH）中的疗效。

方法

纳入25例分娩出Rh阳性婴儿的未致敏Rh阴性母亲。在分娩前通过KBT和使用异硫氰酸荧光素标记的BRAD - 3抗体的FC确定FMH的存在，在分娩后通过KBT和FC确定FMH的存在。

结果

分娩前，FC检测到19例（76%）患者有FMH，KBT检测到23例（92%）患者有FMH；分娩后，FC检测到21例（84%）患者有FMH，KBT检测到23例（92%）患者有FMH。KBT和FC检测的分娩后样本中FMH的平均体积分别为0.34±0.26 ml（范围0.05 - 1.2 ml）和0.37±0.57 ml（范围0.02 - 2.6 ml）。KBT和FC估计的分娩后FMH体积相关性良好（r = 0.75；组内相关系数α = 0.73）。在0.1 - 0.5 ml范围内，KBT和FC之间的一致性更高（kappa = 0.65；p < 0.01）。