Estimation of fetomaternal haemorrhage using flow cytometry in antenatal care patients at an tertiary care hospital in Western Maharashtra

Background

Fetomaternal haemorrhage (FMH), in which foetal red blood cells enter maternal circulation, can cause complications like foetal anaemia, hydrops foetalis, alloimmunisation and foetal death. A notable gap exists in the literature regarding FMH quantification in the Indian patient population vis-a-vis the Western population. This study estimated severe FMH using flow cytometry (FCM) in antenatal patients at a tertiary care hospital in Western Maharashtra.

Methods

This single-centre, prospective observational study was conducted over two years in our institute on 100 consenting antenatal patients. Venous blood samples were analysed with dual-colour FCM to quantify foetal red blood cells, and FMH volume was calculated.

Results

Among the 100 antenatal patients, 54% were primigravida with a mean age of 25.68 years. Severe FMH (>30 ml) was detected in 40% of participants using FCM. Most mothers (94%) and newborns (97%) were RhD positive, with no active alloimmunisation cases. Statistical analysis showed no significant links between FMH and maternal age, blood group, parity, delivery type, haemoglobin levels, gestational age, or newborn gender, except for a significant (p = 0.032) association with Rh status.

Conclusion

Presence of severe FMH in up to 40% of our study population indicates that severe FMH in present Indian subset of antenatal care (ANC) clientele is a considerable phenomenon and underscores the need to conduct research in Indian population in this direction.

Similarly, the modality for FCM for FMH evaluation in Indian patient clientele should be considered to all the high-risk ANC where severe FMH is expected.