Kleiheur Bethke test is done for?
Ans. (b) Fetomaternal haemorrhage(Ref: Oski's Pediatrics: Principles & Practice, chapter 66; Dacie 11th/pg 307)APT test for differentiation of fetal & adult (maternal) hemoglobin in stool or vomitusMix 1 volume of sample with 5 volumes of water.Centrifuge mixture and remove clear-pink supernatant solution containing hemoglobin.Mix 1 ml of 1% sodium hydroxide with 4 ml supernatant and observe color change after 2 minutes.#Remains pink: Hemoglobin F#Turns yellow-brown: Hemoglobin A (maternal blood)A common approach to evaluating FMH is the rosette test to screen for the presence of fetal cells followed by the Kleihauer-Betke acid elution method to quantify the magnitude of feto-maternal bleed.The Kleihauer-Betke acid elution method:Quantitative estimate of the volume of FMH based on different solubility properties of HbF&HbA.On a peripheral smear treated with an acidic solution & counterstained, red cells containing acid-soluble HbA appear as pale ghosts compared to deeply red stained red cells containing acid-resistant HbFCan also be used to detect HbF containing cells in p-thalassemia, hereditary persistence of hemoglobin F, sickle cell disease &myelodysplastic syndrome.Increased HbF is also found in congenital red cell aplasia (Blackfan-Diamond syndrome) & congenital aplastic anemia (Fanconianemia), JMML, presence of erythropoietic stress (haemolysis, bleeding, recovery from acute bone marrow failure) and in pregnancy.
Cephalopelvic disproportion
Fetomaternal haemorrhage
Determining karyotype of normal fetus
Diagnosing fetal infections
Misc. (R.B.C)