Clinical Outcomes of Pregnant Women with Fetomaternal Hemorrhage Detected by Flow Cytometry
Y Zhang, SY Yasin, P Ruiz. University of Miami, Miami, FL
Background: The purpose of this study was to evaluate the clinical outcomes of pregnant women with fetomaternal hemorrhage (FMH) detected by flow cytometry over the last four years at Jackson Memorial Hospital (JMH).
Design: We evaluated results from JMH using the flow cytometric method (FCM) to detect fetal red blood cells (RBCs) based on the anti-hemoglobin F (HbF) monoclonal antibody method, a positive test that is correspondent with FMH.
Results: During the last four years, 26 pregnant women had measurable fetal RBCs (>0.15%) in maternal blood among 267 blood samples sent for the test. Seventeen (17) of the 26 positive patients had intrauterine fetal demise (IUFD); 2 patients had motor vehicle accidents during the pregnancy when the tests were sent; 6 pregnant women showed clinical symptoms and signs of threatened preterm labor. Autopsies were performed on 11 of 17 IUFD fetuses. In 5 of the 11 autopsies, the cause of death was related to FMH. One fetus had multiple congenital anomalies, while in the remaining 5 cases, the cause of death was initially undetermined. Retrospectively, we reevaluated FMH in all 11 autopsy cases by calculating the fetal blood loss during the pregnancy and we found that FMH may be counted as the cause of all 5 undetermined autopsy cases; thus, FMH was overall associated with 10 of the 11 autopsies.
Conclusions: Cytofluorographic analysis of fetal RBC is a precise and quick method to detect FMH during pregnancy. There is high correlation between the presence of FMH and threatened preterm labor and IUFD. Our results suggest that obstetricians and pathologists can utilize flow cytometric measurement of fetal RBC as a powerful tool when considering the possibility of FMH as a cause of death of IUFD.
Tuesday, March 10, 2009 1:00 PM
Poster Session IV # 154, Tuesday Afternoon