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Value of Kleihauer testing after administration of anti-D immunoglobulin

BMJ 1994; 309 doi: https://doi.org/10.1136/bmj.309.6949.240 (Published 23 July 1994) Cite this as: BMJ 1994;309:240
  1. J K M Duguid,
  2. I Bromilow
  1. National Blood Transfusion Service Mersey and North Wales, Liverpool L7 8TW
  1. Correspondence to: Dr Duguid
  • Accepted 7 February 1994

The standard dose of 500 IU of anti-D immunoglobulin given in Britain to Rh D negative mothers postnatally is lower than that used in Europe, the United States, and Canada, where 1000-1500 IU is the routine dose. In Britain a Kleihauer test is performed after the 500 IU dose is given.1 The results of this test should indicate the volume of fetomaternal haemorrhage that has occurred and whether a further dose of anti-D immunoglobulin is required. Kleihauer testing is not performed routinely in Europe, the United States, or Canada as the higher dose of anti-D immunoglobulin used prevents Rh sensitisation in all but 0.3% of cases.

Use of the Kleihauer test in Rh D negative mothers who have been given anti-D immunoglobulin is intrinsically incorrect as the test measures fetal haemoglobin and not …

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