The Fetal Cell Stain test is also known as the Kliehauer Betke or KB test. Quantitative test performed to quantify the volume of the Fetal Maternal Hemorrhage (FMH). This test is performed if a fetal screen (semi-quantitative test) is positive indicating that a FMH > 15 ml of fetal red cells may have occurred. This quantitative test needs to be performed to determine the correct dosage of Rh Immune Globulin to cover the FMH.
Useful For
The quantitative assessment of a Fetal Maternal Hemorrhage (FMH). The estimated FMH volume is used to calculate the appropriate dose of Rh Immune Globulin (Rhogam; RhIG).
Method Name
Manual Stain: Kleihaur-Betke Method
Aliases
Fetal Cell Stain; Kleihauer-Betke Stain; Fetal Hemoglobin Determination, Fetal Cell Stain, Fetalstain, Fetal Stain
Specimen Type
Whole Blood
Specimen Required
Large lavender-top (EDTA) tube, approximately 7 mL
After the patient is positively identified, the sample is drawn and fully labeled with the following information either electronically or handwritten:
- Patient’s full First and Last Name
- Date of Birth or Medical Record Number (MRN#)
- Date and Time specimen was drawn
- Blood Bank Armband Number (BBID) (see below for more information)
- Identify of the person who collected the specimen (Ex: Cerner ID or personnel initials)
All inpatients, or patients potentially receiving a transfusion, must have a blood bank armband (BBID) applied to their wrist and the Blood Bank ID (BBID) number written on the tube. This blood bank armband is a secondary patient identifier that helps ensure a safe and accurate transfusion. Specimens received without a blood bank armband will be rejected. See special instructions for more information.
Specimen Minimum Volume
3.0 mL
Specimen Stability Information
Specimen should be refrigerated and sent to Albany Medical Center within 24 hours.
Rejected Due To
- If the patient’s full first and last name and date of birth are not clear, accurate, and/or readable the specimen must be rejected.
- If the Blood Bank Armband Number (BBID) from the Blood Bank Armband is missing, inaccurate, illegible and/or can not be confirmed on all inpatient and outpatient potential transfusion specimens, the specimen must be rejected and sample redrawn.
- Specimens may be rejected for insufficient quantity and/or quality reasons (Ex: Hemolysis, Clotted dilution, etc).
- If there is any doubt as to the identity of the sample, a new sample must be obtained.
Special Instructions
This test should only be used to detect and quantify the extent of fetomaternal hemorrhage, in pregnant or post-partum women who need to be assessed for Rhogam or fetal-maternal bleeds. For all other testing, including routine post-partum assessments for Rhogam, please order fetal cell screen. If the fetal cell screen is positive, the fetal cell stain will automatically be performed to determine the correct dosage of rhogam.
Performing Laboratory
Albany Medical Center
Reference Values
Reported in percent (%) of fetal cells.
Negative (<0.1%): indicated a less than 15 mL bleed has occurred and one vial of Rh Immune Globulin is sufficient.
Positive (<0.1% and above): indicates that a greater than 15 mL bleed has occurred, result will quantify the percent of fetal cells, additional vials of Rh Immune Globulin may be required. Please contact the Blood Bank for assistance.
Analytical Time
Results available the next day
Specimen Retention Time
10 Days
Reflex Tests
If the test is positive, additional vials of Rh Immune Globulin may be required. Please contact the Blood Bank.
Analytical Time
Results available the next day