The assessment of fetal-maternal hemorrhage by an enzyme-linked antiglobulin test for Rh immune globulin recipients

An enzyme-linked antiglobulin test has been developed to detect and quantitate fetal-matemal hemorrhage. The test is applicable to postpartum screening of Rh immune globulin candidates. The enzyme-linked antiglobulin test has greater sensitivity than agglutination tests; it has fewer false positive results than acid-elution detection methods and offers advantages for use in routine clinical laboratories. Postpartum samples from 186 mothers were assessed by the enzyme-linked antiglobulin test; only 20 samples (10.75%) had detectable fetal cells, and no patient had bleeding of more than the limit of 30 ml of whole blood for one vial of Rh immune globulin. No clinical or historic factors could predict the patient at high risk for fetal-matemal hemorrhage. The use of the enzyme-linked antiglobulin test also could permit the reduction of the postnatal Rh immune globulin dosage and salvage much of the Rh immune globulin now administered.