Kleihauer
A Kleihauer is indicated in RhD negative patients with bleeds and sensitising events after 20 weeks gestation and post delivery, which should be sent with a cord blood sample to determine the newborns Rh(D) status.
In the event of a result suggesting a Fetal Maternal Haemorrhage (FMH)>4mls the sample will be referred to the National Blood Service for Flow Cytometry to determine the total volume of RhD positive cells.
An appropriate dose of Anti-D will be issued to cover the size of the FMH. For Antenatal bleeds please consult the Haematology SpR for advice.
http://tww-wafr/WAFR-FAD/Applications/ClinicalGuidance/User/Details.aspx?id=4971
N/A
Griener Vacutte K2EDTA 4 mls whole blood for adult tube (Purple top)
Timing of samples - The maternal sample for FMH estimation should be taken when sufficient time has elapsed to allow fetal cells to be distributed within the maternal circulation following delivery, manual removal of placenta or sensitising event. A period of 30-45 minutes is considered adequate.
Other Factors Affecting Results:
Hereditary Persistence of Fetal Haemoglobin (HPFH) and Delta-Beta -Thal. may give false positive results if assessing prophylactic Anti-D requirements. If this is the case, samples may be sent to NHSBT for Flow Cytometry. Patients with sickle cell disease or β-thalassemia are known to show poor elution of some of their red blood cells. This can affect interpretation of results.
St Thomas' Hospital
North Wing, 5th Floor
St Thomas' Hospital
Westminster Bridge Road
London SE1 7EH
Blood Transfusion Laboratory
Guy's Hospital
Southwark Wing, 4th Floor
Great Maze Pond
London SE1 9RT
Last updated: 16/05/2022