Evaluation of FMH QuikQuant for the detection and quantification of fetomaternal hemorrhage

Pastoret, Cedric; Priol, Jérôme Le; Fest, Thierry; Roussel, Mikaël

doi:10.1002/cyto.b.21052

Cited by 15 publications

(18 citation statements)

References 33 publications

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“…These 'low' values artificially inflate the imprecision between the WinList replicate analyses. If these values are excluded, then the CVs would be approximately 4% and 7% for the manual intra-analyst and interanalyst analyses, respectively, which is in keeping with previous reports [6,[9][10][11]. If such variation is observed in expert analyses, we anticipate that it would even higher for nonexperts, where CV is typically reported in the range of 10-30% from regional proficiency testing programs for FMH testing by flow cytometry, such as those run by the College of American Pathologist or UK NEQAS programs.…”

Section: Discussionmentioning

confidence: 61%

Automated quantitation of fetomaternal hemorrhage by flow cytometry for HbF‐containing fetal red blood cells using probability state modeling

Hunsberger¹,

Bagwell²,

Davis³

2013

Int J Lab Hematology

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Section: Discussionmentioning

confidence: 61%

Automated quantitation of fetomaternal hemorrhage by flow cytometry for HbF‐containing fetal red blood cells using probability state modeling

Hunsberger¹,

Bagwell²,

Davis³

2013

Int J Lab Hematology

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“…Although anti‐HbF FC calculated higher FMH volumes compared to the results generated by the currently used anti‐D FC method, this overestimation is insignificant at lower FMH volumes as one 1500 IU dose of anti‐D prophylaxis is issued to treat an FMH of <12 mL in our institution. Anti‐HbF FC allows FMH to be detected in women regardless of their RhD status and would prove helpful in haemoglobin‐based diseases, such as hereditary persistence of fetal haemoglobin (HPFH) or myelodysplastic syndromes (Pastoret et al, ). However, using the anti‐D FC method, it is easier to detect FMH in RhD‐negative women with an RhD‐positive infant as it shows greater peak separation.…”

Section: Discussionmentioning

confidence: 99%

The prevalence of an elevated F cell population in a maternal and gynaecology cohort

Cormack

Guilfoyle

Flynn

2019

Transfusion Medicine

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SUMMARY Objectives This study aimed to determine F cell prevalence in a cohort of maternal and gynaecology specimens using QuikQuant anti‐HbF flow cytometry (FC) kit and to investigate if the presence of maternal F cells can lead to fetomaternal haemorrhage (FMH) overestimation. Background The gold standard to estimate FMH is the Kleihauer–Betke test (KBT). The KBT has proved to be insufficiently sensitive to detect low numbers of circulating fetal cells due to the presence of maternal F cells. At present, the prevalence of false positive KBT results due to raised maternal F cell population, defined as >5%, is poorly characterised. Methods A total of 120 specimens were tested for the presence of F cells and fetal cells by KBT and anti‐HbF FC. The results calculated were compared to determine FMH overestimation. Results Of our cohort, 32% showed an elevated F cell population, of which 69% (27 of 39) were clinically significant according to KBT (>2 mL FMH). The mean FMH volumes by KBT and anti‐HbF FC were 3·90 mL (0·20–35·40 mL) and 4·09 mL (0·20–9·70 mL), respectively. Conclusion The study highlighted that an elevated F cell level could be found in the cohort tested, with an F cell level of >10% causing significant FMH overestimation by KBT.

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“…In our study we use FCM method to determine FMH volume that occurred during labor and prefer it than other techniques as it has better precision, can prevent false-positive results in patients with increased F-cell counts due to other conditions [9] [10] [11]. Because maternal F cells have been reported to increase during the second trimester of pregnancy and misidentification of these F cells as fetal RBCs may occur especially in pregnant women with hereditary persistence of fetal hemoglobin, sickle cell disease, thalassemia, or a hematologic malignancy [27] [28] [29]. Formally (KBT) was based on the microscopic counting of fetal RBCs within the maternal blood on blood film, under acid conditions, it is inaccurate, leading to inappropriate dose of anti-Rh D immunoglobulin [13]- [30].…”

Section: Discussionmentioning

confidence: 99%

Fetal RBCs Potential in Obstetric Protocols to Minimize Fetomaternal Hemorrhage

Abo-Elwafa¹,

Ismail²,

Hassanin³

et al. 2017

OJBD

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Background: During pregnancy a small number of fetal RBCs (Red Blood Cells) enter maternal blood without risk, and incidence of significant fetomaternal hemorrhage (FMH) and isoimmunization depends on how much fetal blood enters maternal circulation; the use of flow cytometer (FCM) in FMH detection is considered the best laboratory technique. Aims: To evaluate role of FCM in FMH estimation to optimize delivery protocols and decrease isoimmunization. Subject and Method: 100 pregnant women at labor were included, equally classified into early cord clamping (ECC) and delayed cord clamping (DCC) groups, each including 25 women delivered vaginally and 25 with caesarian section; the control groups included 20 non-pregnant females, 20 at 3 rd trimester and 20 neonates. Fetal RBCs were done on Becton Dickinson (B.D) FCM, and the reagents used were 5-Glutaraldehyde 0.5% Sigma cat. G5882, flouroscine isothiocyanite (FITC) anti-hemoglobin F (Hb-F) cat. 555748, anti-carbonic anhydrase, Triton-X100 solution and Alsever's solution cat. HFH-11, 0.1% phosphate buffer saline/bovine serum albumin (PBS/BSA). Statistical Analysis: Mann Whitney's U-test, Chi-squared, Fischer's Exact tests, and SPSS for windows version 15.0. Results: There was a significant increase in the volume of the FMH in the ECC compared to DCC groups (p < 0.0001), also in the vaginal delivery comparing to caesarian section subgroups within the DCC group (p < 0.01), and in the ECC compared to DCC within caesarian section subgroup (p < 0.02). Conclusion: Fetal RBCs estimation by FCM is good; perinatal laboratory test should be done in routine investigations, as a guide for obstetric techniques that can alter FMH volume and decrease subsequent isoimmunization.

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Evaluation of FMH QuikQuant for the detection and quantification of fetomaternal hemorrhage

Cited by 15 publications

References 33 publications

Automated quantitation of fetomaternal hemorrhage by flow cytometry for HbF‐containing fetal red blood cells using probability state modeling

Automated quantitation of fetomaternal hemorrhage by flow cytometry for HbF‐containing fetal red blood cells using probability state modeling

The prevalence of an elevated F cell population in a maternal and gynaecology cohort

Fetal RBCs Potential in Obstetric Protocols to Minimize Fetomaternal Hemorrhage

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