Evaluation of Automatic Blood Analyzer as Screening Method in Fetomaternal Hemorrhage.

Marcella R Cardoso,Ricardo Barini,Caroline N De Souza-Araújo,Fernando Guimarães,Maria Cecília R Talarico,Juliana Heinrich-Mouçouçah

doi:10.1155/2019/6481654

Marcella R Cardoso, Ricardo Barini + Show 4 more

Open Access

https://doi.org/10.1155/2019/6481654

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Abstract

Screening of fetomaternal hemorrhage (FMH) is essential in management of fetomaternal antigen incompatibilities of blood. The objective in this study was to evaluate the ability of automatic blood analyzer (ABA) to screen FMH, also comparing this method with flow cytometry (FCM). The contents of fetal red blood cells and fetal hemoglobin were evaluated by FCM and ABA, respectively, using both blood samples of male adults laced with umbilical cord blood diluted at 1/10, 1/100, 1/1,000, and 1/10,000, or blood from puerperal women collected within 48 hours following delivery. FCM had better performance (area under curve, AUC = 0.8723) than ABA (AUC = 0.6569) in detecting fetal blood laced with blood from male adults. At a critical level of 0.5%, ABA indicated that 27.5% of puerperal women would have FMH while FCM did not detect FMH. Our results showed that ABA overestimates FMH and disagrees with FCM on indicating puerperal women with FMH. ABA is inadequate for being used to screen for or to measure FMH.

Highlights

A correct and rapid detection and quantification of fetomaternal hemorrhage (FMH) is essential for the management and treatment of RhD discordant pregnancies
The objective in this study was to evaluate the ability of automatic blood analyzer (ABA) to screen for FMH at critical level of 0.5% which is within the hemorrhage volumes neutralized by standard doses of antiD treatment, comparing ABA with flow cytometry (FCM), a method that has been replacing Kleihauer-Betke test for this end
The accuracy of FCM and ABA to detect fetal blood laced with blood samples from male adults was further evaluated by plotting the receiver operating characteristic (ROC) curves for each of the methods

Summary

Introduction

A correct and rapid detection and quantification of fetomaternal hemorrhage (FMH) is essential for the management and treatment of RhD discordant pregnancies. Automatic blood analyzer is used to define standards of accuracy, reliability, and performance of blood gas tests by measuring parameters of pH, electrolytes, metabolites, and oximetry using spectrophotometry technology as in the case of fetal hemoglobin dosage [13]. Since it discriminates adult and fetal hemoglobin, this device is potentially useful for the evaluation of FMH. The objective in this study was to evaluate the ability of ABA to screen for FMH at critical level of 0.5% which is within the hemorrhage volumes neutralized by standard doses of antiD treatment, comparing ABA with FCM, a method that has been replacing Kleihauer-Betke test for this end

Subject and Methods

Results

Discussion

Conflicts of Interest