FMH - Feto Maternal Haemorrhage

General Information

BCSH guidelines (2009)

https://b-s-h.org.uk/media/15705/transfusion-austin-the-estimation-of-fetomaternal-haemorrhage.pdf

Guidelines state that :

“Flow cytometry tests for a minor D positive population may be required:

• Following a D positive RBC transfusion to a D negative woman of childbearing potential. To estimate or confirm the dose of anti-D immunoglobulin required, as part of the protocol given in the anti-D guidelines (BCSH 2006a), to prevent sensitisation to the D antigen.
• In solid organ transplantation when the donor is D positive and recipient D negative with childbearing potential.”

and

“The sample should be referred for quantification of D positive cells by FC if the FMH is greater than 2 mL by the Acid Elution method”.

FMH by flow utilises the an FITC conjugated monoclonal  anti-D reagent.

Samples within HEFT will automatically be refered for FMH estimation by flow cytometry if found to be high by the Kleihauer method.

Suggested Anti-D dosage takes into account the uncertainty of measurement of FMH measured by flow cytometry in this laboratory. Click here for further information.

Download the FMH request form here

Link to immunophenotyping pages