Hemoglobin or RBCs, fetal, for fetomaternal hemorrhage; differential lysis (Kleihauer-Betke)
CPT4 code
Name of the Procedure:
Fetal Hemoglobin Stain, Kleihauer-Betke Test, Differential Lysis of RBCs for Fetomaternal Hemorrhage
Summary
This test detects fetal red blood cells in a pregnant woman's blood to determine if fetal-maternal hemorrhage has occurred. It uses a staining technique to identify fetal cells due to their higher hemoglobin content compared to maternal cells.
Purpose
The procedure helps to assess the extent of fetal-maternal hemorrhage and determine the need for Rh immunoglobulin therapy in Rh-negative mothers. It ensures the health and safety of both mother and fetus by detecting abnormal bleeding.
Indications
- Suspected fetal-maternal hemorrhage due to trauma, antenatal bleeding, or delivery.
- Rh-negative mothers needing quantification of fetal red blood cells to guide Rh immunoglobulin dosage.
- Certain obstetric procedures like amniocentesis.
Preparation
- No extensive preparation is required.
- Inform the medical provider of any medications or medical conditions.
- Blood sample is drawn, so it may involve cleaning the skin at venipuncture site.
Procedure Description
- A blood sample is taken from the mother.
- The sample is prepared on a slide and stained using the Kleihauer-Betke technique.
- Fetal red blood cells, due to their high hemoglobin content, stain darker than maternal cells.
- A laboratory technician or pathologist counts the percentage of fetal cells.
Tools and equipment: Microscope, staining reagents, glass slides.
Duration
The blood draw takes a few minutes; analysis may take several hours to a day.
Setting
Performed in a hospital or diagnostic laboratory setting.
Personnel
- Phlebotomist or nurse for blood draw.
- Laboratory technician or pathologist for slide preparation and analysis.
- Obstetrician or hematologist for interpretation and further management.
Risks and Complications
Risks are minimal:
- Bruising or minor bleeding at the blood draw site.
- Rarely, infection or excessive bleeding.
Benefits
- Early detection and management of fetal-maternal hemorrhage.
- Appropriate administration of Rh immunoglobulin to prevent hemolytic disease in future pregnancies.
Recovery
No specific post-procedure care is required. Patients can resume normal activities immediately after the blood draw.
Alternatives
- Flow cytometry for detecting fetal red blood cells, which is more accurate but also more expensive and less widely available.
Patient Experience
The blood draw may cause minor discomfort, akin to a standard blood test. No ongoing pain or discomfort is associated with the procedure itself. Pain management is rarely required and usually consists of a simple bandage at the venipuncture site.