[Current role of the Kleihauer-Betke test in monitoring pregnant women].

Abstract

The Kleihauer test is a widely prescribed examination today. However, we propose revisiting certain indications beyond the prevention of maternal-fetal alloimmunization, particularly concerning the adjustment of anti-D immunoglobulin dosage. Indeed, some prescriptions seem irrelevant based on the literature and the experience of the reference center. These include chorionic villus sampling, systematic prescription in cases of reduced fetal movements or metrorrhagia. Other indications could be limited to specific situations, such as direct abdominal trauma, external cephalic version (ECV) in Rh-negative patients, or transplacental amniocentesis in Rh-negative patients. Finally, the Kleihauer test for etiological purposes remains systematically prescribed in cases of intrauterine fetal death (IUFD) or neonatal anemia. Currently, there are no published recommendations on how to proceed in the case of a positive Kleihauer test, except for adjusting the dosage of anti-D immunoglobulins for the prevention of maternal-fetal alloimmunization. With the expertise of the reference center, we propose a management plan adapted to the risks for the fetus and the newborn.