Le diagnostic des hémorragies fœto-maternelles

Abstract : Objective: To determine if the new diagnosis methods available, like flow cytometry, doppler echographic study of the middle cerebral artery, the determination of alpha-fetoprotein, the agglutination test, represent more reliable techniques than the Kleihauer test for the diagnosis of fetomaternal hemorrhage. The special context of maternal-fetal alloimmunization will not be discussed. Materials and methods: Literature review conducted from March 2017 to April 2017 on three databases (Pubmed, ScienceDirect, EM Premium) by using the following keywords : fetomaternal hemorrhage, fetomaternal transfusion, flow cytometry AND fetomaternal hemorrhage. 15 articles were selected. Results: Despite its significant lack of reproducibility, the Kleihauer test remains the reference test in the diagnosis of fetomaternal hemorrhage. However, the flow cytometry test remains a more reliable and accurate technique than the Kleihauer test but has a high cost that can limit its use. The other methods studied are not generalizable: peak systolic velocity in the middle cerebral artery is an indirect indicator of anemia irrespective etiology ; the determination of alpha-fetoprotein is a poorly specific indicator; the agglutination and Rosette tests are too restrictive because they are limited to negative patients. Conclusion: The lack of standardization of the Kleihauer test tends to ameliorate with the development in recent years of automata improving its reproducibility. Flow cytometry test remains a promising technique more and more widespread.
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https://dumas.ccsd.cnrs.fr/dumas-01946523
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Submitted on : Thursday, December 6, 2018 - 10:29:00 AM
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Julie Gaucher. Le diagnostic des hémorragies fœto-maternelles. Gynécologie et obstétrique. 2018. ⟨dumas-01946523⟩

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