This quantitative laboratory procedure determines the volume of fetal blood in the maternal circulation. It is typically performed after suspected fetomaternal hemorrhage, such as following trauma or certain obstetric complications. The process involves counting fetal and maternal red blood cells on a stained blood smear and using this ratio to estimate the amount of fetal bleeding. For example, if 5 fetal cells are found per 1,000 maternal cells, and the maternal blood volume is estimated at 5,000 mL, the fetal bleed would be calculated as approximately 25 mL. This quantification allows for accurate dosing of Rho(D) immune globulin (RhIg) to prevent Rh alloimmunization in Rh-negative mothers.
Accurate assessment of fetomaternal hemorrhage is critical for the prevention of Rh alloimmunization, a potentially serious condition affecting future pregnancies. Prior to its development, significant morbidity and mortality were associated with Rh incompatibility. This method enables precise determination of the necessary RhIg dosage, minimizing the risk of antibody formation against fetal red blood cells and safeguarding subsequent pregnancies. Proper dosing ensures effective neutralization of fetal antigens and provides optimal prophylaxis.