Betke-Kleihauer Stain (Fetal Hemoglobin Stain, Kleihauer-Betke Stain, K-B)

Norm of Betke-Kleihauer Stain (Fetal Hemoglobin Stain, Kleihauer-Betke Stain, K-B)

		HBF Cells
Adults		<2%
Children
	Newborn	60%–90%
	6 months	<5%
	1 year	<2%

 

Usage of Betke-Kleihauer Stain (Fetal Hemoglobin Stain, Kleihauer-Betke Stain, K-B)

Assessment of fetal-maternal hemorrhage in the newborn for determination of the amount of Rh immune globulin (RhoGAM) needed. Routinely performed on RhD-negative women after the birth of an RhD-positive child.
Increased of Betke-Kleihauer Stain (Fetal Hemoglobin Stain, Kleihauer-Betke Stain, K-B)
Anemia (aplastic, congenital hemolytic, myeloblastic, myelophthisic, untreated pernicious, refractory, sickle cell, sideroblastic, spherocytic), diabetes, erythroleukemia, Fanconi's anemia, hereditary persistence of fetal hemoglobin (HPFH), hyperthyroidism, hypothyroidism, infants (small-for-gestational-age, with chronic intrauterine anoxia, with developmental abnormalities), leakage of fetal hemoglobin into maternal bloodstream, leukemia (all types, acute, chronic), myelofibrosis, paroxysmal nocturnal hemoglobinuria, pregnancy, thalassemia, thyrotoxicosis, and trisomy D syndrome. Drugs include anticonvulsants.

 

Description of Betke-Kleihauer Stain (Fetal Hemoglobin Stain, Kleihauer-Betke Stain, K-B)

This test measures the amount of hemoglobin present in the fetal form (HbF) compared to the adult form (HbA). When blood is present in the stool, emesis, or mucus of a newborn, this test differentiates “swallowed blood syndrome” as a result of maternal bleeding from infant gastrointestinal hemorrhage.

 

Professional Considerations of Betke-Kleihauer Stain (Fetal Hemoglobin Stain, Kleihauer-Betke Stain, K-B)

Consent form NOT required.
Preparation

1. Tube: Lavender topped, or obtain a clean container for the mucus specimen.

 

Procedure

1. Draw a 4-mL blood sample.
2. For gastrointestinal or mucus specimens from an infant, use a clean glass or plastic container to collect a small amount of emesis, stool, or mucus.

 

Postprocedure Care

1. None.

 

Client and Family Teaching

1. Cord blood may be sent as a positive control.
2. Results are normally available within 24 hours.

 

Factors That Affect Results

1. Reject hemolyzed specimens or specimens received more than 6 hours after collection.
2. Smears must be fixed within 1 hour after preparation.

 

Other Data

1. A newborn cord blood specimen is recommended as a source of fetal blood to be used as a positive control.
2. Flow cytometry is more precise than Kleihauer-Betke manual technique.