Quantitation of red blood cells containing fetal hemoglobin is used to determine the extent of fetal-to-maternal hemorrhage. This is important in estimating the dosage of RhIg for RhD-negative mothers, but also in evaluating complicated pregnancies or those involving trauma, and explaining fetal or newborn distress. Red blood cells containing fetal hemoglobin may be found in individuals of any age, but in lower amounts. These cells are then termed “F” cells. Increased levels of “F” cells may also be of clinical significance in order to identify other conditions such as Hereditary Persistence of Fetal Hemoglobin, sickle cell anemia and Thalassemia Major. The advantages of using this flow cytometric assay over the Kleihauer-Betke test is that it is much more rapid, accurate, and less labor intensive.
Flow Cytometry (BD FACS Calibur) and Invitrogen R-PE-conjugated Monoclonal Antibody Directed to Fetal Hemoglobin
Fetal cells or F cells are identified by intracytoplasmic staining of fetal hemoglobin in red blood cells using a flow cytometric assay. The percentage of Hemaglobin F is determined using specialized BD software (CellQuest™)
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1. Monoclonal Antibodies Directed to Human Fetal Hemoglobin (Hgb F), Caltag Laboratories, 10/99.
2. Determining Fetal-Maternal Hemorrhage with Flow cytometry., Advance for Medical Laboratory Professionals, by Karen R. Tamel,MS, MT (ASCP) SI, June 5, 2000, (pp. 18-21).
3. Detection of Hgb Variants in Erythrocytes by Flow cytometry, Cytometry 35, by Thomas A. Campbell, Russell E. Ware, and Marsha Mason.,1999, (pp. 242-248).
4. A flow-cytometric equivalent of the Kleihauer test, Vox Sanquinis, by Nelson M, Zarkos K, Popp H, Gibson J, 1998 : 75, (pp-234-241).
5. Quantitation of HgF Containing RBC’s by Flow Cytometry, Bruce H.Davis,M.D. & N.C. Bigelow , MT, personal communication, 11/99.
6. Trillium Diagnostics, LLC / FETALTROL™ control package insert.