Fetomaternal transfusion of fetal RBCs in mother can be detected by: UPSC 08; TN 08; AIIMS 10
First, I need to recall the methods used for this. The main test I remember is the Kleihauer-Betke test. It's a method that uses acid elution to detect fetal hemoglobin in maternal blood. Fetal RBCs have HbF, which is resistant to acid elution, so they stain pink, while maternal cells lose their hemoglobin and appear pale. This test is crucial for determining the volume of fetal blood in the mother, which is important for Rh immunization management.
Other possible options might include Coomb's test, which is for detecting antibodies on RBCs, but that's not for quantifying fetal cells. Flow cytometry could be another method, using specific markers like CD71 or glycophorin A to identify fetal cells. But Kleihauer-Betke is the classic one. Maybe some other tests like PCR for fetal DNA? Although that's more for non-invasive prenatal testing.
So, the correct answer should be Kleihauer-Betke test. The wrong options would be Coomb's test, flow cytometry, and maybe PCR. Each of these is incorrect because they don't directly measure fetal RBCs. Coomb's is for antibodies, flow cytometry is a more modern alternative but not the standard, and PCR isn't used for this purpose. The clinical pearl here is that Kleihauer-Betke is essential for calculating the dose of Rh immunoglobulin needed to prevent Rh sensitization.
**Core Concept**
Fetomaternal transfusion involves fetal red blood cells entering the maternal circulation, detectable by methods targeting fetal hemoglobin (HbF) or fetal RBC markers. The Kleihauer-Betke test is the gold standard for quantifying fetal RBCs in maternal blood.
**Why the Correct Answer is Right**
The Kleihauer-Betke test uses acid elution to differentiate fetal RBCs (retaining pink HbF) from maternal RBCs (losing hemoglobin and appearing pale). Fetal RBCs are resistant to acid due to HbF's structural stability, enabling visualization and quantification. This test is critical for calculating Rh immunoglobulin requirements in Rh-negative mothers to prevent anti-D antibody formation.
**Why Each Wrong Option is Incorrect**
**Option A:** Direct antiglobulin test (Coombs test) detects antibodies bound to RBCs, not fetal cells.
**Option B:** Flow cytometry can identify fetal cells via CD71 or glycophorin A but is less commonly used than Kleihauer-Betke.
**Option C:** PCR for fetal DNA detects free fetal DNA in maternal blood, used in non-invasive prenatal testing, not RBC transfusion.
**Clinical Pearl / High-Yield Fact**
Kleihauer-Betke test is indispensable for estimating fetal-maternal hemorrhage volume. Underestimation risks Rh sensitization; always use this test in Rh-negative mothers after trauma or delivery.
**Correct Answer: C. Kleihauer-Betke test**