RESUMO
Kleihauer examination of peripheral blood cannot be used reliably to detect transplacental fetal-maternal haemorrhage in mothers with hereditary persistence of fetal haemoglobin (HPFH). In Rh(D) negative pregnancies diagnostic confusion with a large fetal-maternal haemorrhage could result in the administration of inappropriately excessive amounts of anti-D immunoglobulin, and the inability to diagnose and quantify transplacental haemorrhage in maternal HPFH by current methods could result in insufficient anti-D administration and subsequent Rh(D) sensitisation. Accordingly, a method to detect and quantify fetal-Rh(D) positive maternal haemorrhage using erythrocyte fluorescent immunocytometry was developed. An indirect immunofluorescence method with IgG anti-D immunoglobulin as the primary antibody was used, combined with quantitative analysis on a fluorescence activated cell sorter. The method was accurate, specific, and sensitive and could detect a contaminating population of 0.1% Rh(D) positive cells in Rh(D) negative blood--a level of fetal-maternal haemorrhage well covered by a single dose of 500 IU of anti-D immunoglobulin.
Assuntos
Hemoglobina Fetal/análise , Transfusão Feto-Materna/diagnóstico , Citometria de Fluxo , Hemoglobinopatias/genética , Imunoglobulinas , Isoanticorpos , Adulto , Separação Celular , Feminino , Humanos , Imunoglobulina G , Peptídeos/sangue , Gravidez , Sistema do Grupo Sanguíneo Rh-Hr , Imunoglobulina rho(D)RESUMO
In an attempt to reduce the cost of testing for anti-human immunodeficiency virus (HIV) we looked at the possibility of recycling the Wellcozyme (R) HIV antigen bound wells; our findings showed that there was no significant reduction in sensitivity of the test samples or controls when run in parallel with new plates. It was concluded that the use of recycled plates was a cost effective means of performing more tests.