Imperial Collage Healthcare

Fetomaternal haemorrhage test (Kleihauer)

Test Background

Transplacental haemorrhage, commonly referred to as Fetomaternal haemorrhage (FMH), may occur during pregnancy or at delivery. The presence of fetal cells in the maternal circulation could lead to maternal immunisation to the RhD antigen if the mother is RhD negative and the baby RhD positive.

Clinical Indications

Fetomaternal haemorrhage can result in haemolytic disease of the fetus and newborn (HDFN) in subsequent pregnancies. It is important to assess the volume of FMH to determine the dose of anti-D immunoglobulin required by a non-sensitised RhD negative woman to prevent sensitisation

Reference Range

Not applicable

Sample Required
EDTA (purple top)

Sample Volume
3 or 4 mL

Turnaround Time

Routine 48 hours


The sample should be taken within 1 hour of a manual delivery, manual removal of the placenta or a sensitising event and the result should be available within 72 hours so that additional anti-D can be administered if required.

This test may be sent to our reference laboratory for confirmation by flow cytometry.

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