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The Quantification of Fetomaternal Hemorrhage by an Enzyme‐Linked Antibody Test with Glutaraldehyde Fixation

A modified enzyme‐linked antiglobulin test (ELAT) for quantifying D‐posi‐tive red blood cells in the circulation of D‐negative pregnant women is described. The antibody‐antigen bond was stabilized and the problem of hemolysis eliminated by the use of 0.05% glutaraldehyde. The r value for the standardization curves for measuring cord RBC in mixtures was 0.98; coefficient of variation 5.8%. Reproducible quantitation of 0.125% D‐positive cord RBC mixed with D‐negative RBC was demonstrated. In comparative studies of artificial mixtures, Kleihauer‐Betke results for more than 1% cord RBC were 50–100% greater than the true values. In several examples of large fetomaternal hemorrhages, the ELAT results matched the clinical data more closely than the Kleihauer‐Betke based estimates. 2 ml of fetal RBC in a 1,600‐ml red cell mass can be quantified using the modified ELAT.