Clin Pediatr Hematol Oncol.  2016 Oct;23(2):158-161. 10.15264/cpho.2016.23.2.158.

Massive Fetomaternal Hemorrhage Diagnosed with High-performance Liquid Chromatography

• Lee JY
• Kim KH
• Kong SG

• KMID: 2358371
• DOI: http://doi.org/10.15264/cpho.2016.23.2.158

Abstract

Massive fetomaternal hemorrhage (FMH) is a major cause of unexplained fetal death and neonatal anemia. FMH can be diagnosed using the Kleihauer-Betke test or flow cytometry by identifying the presence of fetal red cells in the maternal blood. However, timely diagnosis is a challenge because many hospitals lack the equipment needed to perform such tests. The authors experienced a case of FMH diagnosed via high-performance liquid chromatography (HPLC) which is generally used in measuring glycated hemoglobin (HbA1c) in a patient with unexplained neonatal anemia. A girl aged 2 days was transferred to our hospital for showing pallor and a hemoglobin level of 5.0 g/dL. HPLC revealed 3% fetal hemoglobin (HbF) in the maternal blood. HPLC is a quick test for quantifying HbF that is readily available in many hospitals and could serve as a promising alternative for diagnosing FMH.

Keyword

Fetomaternal hemorrhage; HPLC; Fetal hemoglobin

MeSH Terms

Anemia, Neonatal
Chromatography, High Pressure Liquid
Chromatography, Liquid*
Diagnosis
Female
Fetal Death
Fetal Hemoglobin
Fetomaternal Transfusion*
Flow Cytometry
Hemoglobin A, Glycosylated
Humans
Infant, Newborn
Pallor
Pregnancy
Prothrombin Time
Fetal Hemoglobin