15 ANTI D IMMUNOGLOBULIN Date Issued: January 2005 15.2 The Kleihauer Test Date Revised: July 2009 Section 15 Review Date: July 2011 Transfusion Medicine Protocols Authorised by: KEMH & PMH Transfusion Committees Child & Adolescent & Women’s & Newborn Health Services Review Team: KEMH & PMH Transfusion Committees Perth Western Australia ALSO see WNHS Intranet Clinical Guidelines Section A Medications 3.13 Rh D Immunoglobulin Section B: Obstetric and Midwifery Guidelines, 2.4 Blood Grouping, Antibody Screening and Rh D Immunoglobulin. 15.2 THE KLEIHAUER TEST Kleihauer tests are not required in the first trimester as one minidose of Rh D Immunoglobulin will be sufficient to cover all events. Following FMH or delivery, a Kleihauer Test performed on a maternal sample is used to determine if additional doses of prophylactic Rh D Immunoglobulin are required. A Negative Kleihauer Test indicates that one dose of Rh D Immunoglobulin is sufficient. It is not necessary to wait for the result before administering Rh D Immunoglobulin. A standard full dose of Rh D Immunoglobulin (625 IU) is sufficient to destroy up to 6mL of packed fetal red cells. For FMH in excess of 6mL a repeat Kleihauer Test is required 48 hours after administration of Rh D Immunoglobulin to ensure effective prophylaxis. HTMP 15.2 Page 1 of 1 All guidelines should be read in conjunction with the Disclaimer at the beginning of this manual.