Pathology Handbook

Kleihauer test for foetal cells in maternal blood

Synonyms

Cord & maternal testing

Clinical Indications

To determine the presence of foetal cells in maternal circulation

Request Form 

Request via ICE

Availability

Performed 3 times per week

Specific Criteria

Mother must be Rhesus negative, or have suffered an injury likely to cause foetal bleeding

Patient Preparation

Sample collection minimum of 1 hour post delivery

Turnaround Time

Within 72 hours. If indicated on initial screen result a sample may be sent to the referral centre (NBS) for flow cytometric analysis for bleed estimation

Specimen

Whole Blood (Maternal and Cord samples)

Pink top (EDTA) tube and Purple top tube(EDTA) for Maternal blood and Cord bloods

Samples must be labelled in full and signed by person collecting the blood, in accordance with the Blood Transfusion specimen acceptance policy

Volume

6ml (maternal blood) + 4.5ml  (cord sample)

Container

Pink ETDA BT

Vacutainer purple top

Causes for Rejection

Unlabelled /unsigned sample. Incorrect or inadequate patient identifiers provided. Insufficient sample volume. Poor sample quality due to deterioration, haemolysis, presence of clot.

Interpretation

This is a screening test used to determine the number of foetal cells present in maternal circulation. A count of less than 10 cells per low power microscope field is indicated to be normal and a single dose of Anti D ( given to a mother with a Rh (D) positive child ) is sufficient to destroy the circulating foetal cells. This test may also be used in cases of abdominal trauma during pregnancy, when a foetal bleed may be suspected. The recommended dosage of anti-D will be stated on the test report. Anti- D is available from the Pharmacy Department at Southend