FETAL MATERNAL BLEED FLOWCYTOMETRY

Code
900.1540
Name
FETAL MATERNAL BLEED FLOWCYTOMETRY
Category
None
Department
Send-Out
Start Date
Expiration Date
Synonyms
Fetal Quant by Flow, Kleihauer-Betke alternate
CPT Codes
88184
Site
SBMF
Reference Test
36040
ATLAS Test Code

Specimen Information

Type

Lavender, EDTA

Volume

5.0 ml

Transport Info

Refrigerated

Fasting Required?
False
Patient Instructions

Reference Range

Equal to or less than 0.1%

Methodology

Flow Cytometry

Clinical Significance

This quantitative test should be ordered when it is necessary to measure antepartum fetal-maternal hemorrhage.
If the mother has had a positive result for the qualitative Fetal-Maternal Bleed Screen, this test is automatically performed to calculate the Rh immune globulin (RhoGAM) dosage to be administered.

The test for fetal hemoglobin (HbF) determination can be used in the workup of possible cases of fetal-maternal hemorrhage. Examples of this condition include cases of trauma with suspected placental injury, after amniocentesis, or postpartum in situations of Rh incompatibility between mother and fetus. Rh (D) incompatibility exists when a D-negative mother is pregnant with a D-positive fetus. This occurs in 9–10% of pregnancies. Transplacental hemorrhage can lead to isoimmunization and possible hemolytic disease of subsequent D-positive pregnancies. The ability to quantify fetal-maternal hemorrhage is of clinical significance in the prophylactic treatment of D-negative mothers. Combined antenatal and postnatal therapy of Rh immune globulin (RhIg) can prevent isoimmunization of most women at risk. The amount of RhIg to be given is dependent upon the extent of fetal-maternal hemorrhage.
Compared to other methods for HbF determination, including the traditional Kleihauer-Betke (KB) acid elution technique, flow cytometry using monoclonal antibody directed against HbF has been shown to be far more sensitive in detecting small amounts of fetal blood (as much as 500 times more sensitive). It eliminates the subjectivity of the KB procedure and has been shown to reduce the number of false positives. Linearity (relationship of flow cytometry result to amount of fetal Hg) is also superior to that of the KB method.

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