What is Fetal Anemia?Red blood cells carry oxygen to cells and organs throughout our bodies – without them, our cells would die. Anemia happens when red blood cells are lacking in number or quality, and can’t properly nourish our cells and organs. When this happens to a growing baby during pregnancy, it is called fetal anemia. Show Fetal anemia can range from mild to serious and may cause many complications. In severe cases, the baby’s heart tries to compensate for the lack of red blood cells by pumping extra hard, which can lead to fetal heart failure. Causes of Fetal AnemiaFetal anemia may have several causes, including:
Diagnosing Fetal AnemiaFetal anemia may be detected during pregnancy through prenatal testing. Some tests may be routine, while others may be performed to check specifically for fetal anemia. Prenatal UltrasoundPrenatal ultrasound can detect signs of fetal heart failure or unusual blood flow in a vessel. Maternal Blood TestingMaternal blood testing can detect specific antibodies that may cause anemia in the baby. AmniocentesisAmniocentesis can test the amniotic fluid to determine how red blood cells are breaking down in the fetal circulatory system. A needle is inserted through the mother’s abdomen to collect a sample of amniotic fluid. In most cases, an ultrasound can detect fetal anemia, so an amniocentesis is rarely needed for diagnosis. Fetal Blood SamplingFetal blood sampling tests blood from the umbilical vein to look for anemia. This test is similar to amniocentesis, but the needle is guided by ultrasound into the umbilical vein. Treating Fetal AnemiaMercy maternal and fetal medicine specialists closely monitor and treat fetal anemia to help keep your baby as healthy as possible throughout pregnancy and delivery. In mild cases, monitoring may be all you need to ensure the anemia does not cause problems. Fetal Blood TransfusionIf the anemia is more severe, your baby may need a blood transfusion while in the womb. This procedure is done in the hospital. The blood is transfused through a needle placed into the umbilical vein. Depending on your baby’s anemia, we may recommend additional transfusions. Your care team will discuss your treatment plan with you and answer any questions you may have. Most newborns with fetal anemia are healthy, although jaundice is not uncommon. If your newborn has jaundice that requires treatment, Mercy’s neonatologists are ready to care for your baby with expertise and compassion. Our Neonatal Intensive Care Units offer advanced, round-the-clock care for premature or critically ill babies. Fetal ScreenTest Code FMS Alias/See Also Fetal Maternal Screen, CPT Codes Preferred Specimen BB PINK (PBB) Specimen Stability If there is a delay in testing, store the specimen at 2-6ºC. Reference Range Negative Note: A positive test merely provides evidence of a potentially large feto-maternal bleed and a quantitative test will be required to determine the volume of the feto-maternal hemorrhage. Reflex to Kleihauer-Betke Test to determine the RHIG amount. Clinical Significance Hemolytic disease of the newborn as a result of maternal sensitization to the D (Rho) antigen on fetal red cells can be prevented by the injection of Rh immune globulin (RhIg) prior to and/or within 72 hours of delivery of an Rh-positive infant. Performing Laboratory The CPT Codes provided in this document are based on AMA guidelines and are for informational purposes only. CPT coding is the sole responsibility of the billing party. Please direct any questions regarding coding to the payor being billed. Any Profile/panel component may be ordered separately. Reflex tests are performed at an additional charge. Which test result would provide evidence of fetal blood in maternal circulation?A Kleihauer-Betke test, which detects fetal blood cells in maternal circulation may be ordered. A Kleihauer-Betke test does not diagnose the presence of placental abruption but quantifies the presence of fetal blood into the maternal circulation.
How is fetal maternal hemorrhage detected?When a FMH is suspected, maternal blood can be checked for the presence of fetal red blood cells. Of historical significance is the Rosette test. This is a qualitative screening test that identifies Rh-positive blood in Rh-negative mothers. Even if the Rosette test is positive, a quantitative test is still required.
When do you do the Kleihauer test?Kleihauer test. When the sensitising event is before 20 weeks, because the fetal blood volume is insufficient to exceed that covered by the minimum 500iu anti-D immunoglobulin dose in standard use.. When the woman is known to have immune anti-D. ... . When the fetus/baby is known or predicted by cffDNA testing to be D negative.. What does a positive Kleihauer test mean?What is a positive Kleihauer-Betke test? A positive KB test means there is fetal blood in the maternal circulation. The sensitivity of the KB test is 5 mL, meaning a fetomaternal hemorrhage of less than 5 mL between the fetus and the pregnant individual's circulation may not be detected with this method.
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