Kleiheur Bethke test is done for?
Cephalopelvic disproportion
Fetomaternal haemorrhage
Determining karyotype of normal fetus
Diagnosing fetal infections
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.
Misc. (R.B.C)