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Diagnostic accuracy of Kleihauer–Betke (Kb) testing to predict fetal outcomes associated with fetomaternal hemorrhage: a retrospective cohort study

Journal of Perinatology volume 42, pages 91–96 (2022)Cite this article

Subjects

Abstract

Objective

To evaluate the diagnostic and screening utility of Kleihauer–Betke (KB) testing as a triage tool in predicting adverse fetal outcomes associated with fetomaternal hemorrhage (FMH).

Study design

Single center retrospective cohort study evaluated a primary composite outcome of fetal complications associated with FMH between KB-negative and KB-positive test groups. Screening tests for sensitivity, specificity, positive predictive value and negative predictive value were determined.

Results

641 women (97%) had KB-negative and 22 (3%) had KB-positive tests. The primary composite outcome between KB-negative and KB-positive pregnancies was similar (30% vs. 36%, p = 0.54). Screening exhibited high specificity (97%), however, test sensitivity was poor (4%) with only moderate positive and negative predictive values (36.4 and 69.7%).

Conclusion

Fetal outcomes associated with FMH were not significantly different between KB-positive and KB-negative test cohorts; KB testing offers no diagnostic precision in the emergency triage evaluation of women with suspected FMH.

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Fig. 1
Fig. 2: Distribution of presenting complaints by Kleihauer–Betke (KB) test results.

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Acknowledgements

The authors would like to thank Ariana Fathi and Ola Shaltout for their assistance with data collection.

Author contributions

MA, KM, and MS contributed to conception and design MA, KM, and NM contributed to acquisition of data. MA, KM, JK, and MS contributed to analysis and interpretation of data. All authors contributed to drafting the article or revising it critically for important intellectual content. All authors read and approved the final manuscript.

Funding

MA was supported by the Chisholm Memorial Award (2020-2021; University of Toronto) and NM was supported by the University of Toronto’s Chair’s Summer Student Award.

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Authors and Affiliations

  1. Department of Obstetrics and Gynaecology, University of Toronto, Toronto, ON, Canada

    Melanie C. Audette, Katie Mclean, John Kingdom & Mara Sobel

  2. Faculty of Medicine - University of Toronto, Toronto, ON, Canada

    Melanie C. Audette, Katie Mclean, Niyati Malkani, John Kingdom & Mara Sobel

Authors
  1. Melanie C. Audette
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  2. Katie Mclean
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Correspondence to Melanie C. Audette.

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Audette, M.C., Mclean, K., Malkani, N. et al. Diagnostic accuracy of Kleihauer–Betke (Kb) testing to predict fetal outcomes associated with fetomaternal hemorrhage: a retrospective cohort study. J Perinatol 42, 91–96 (2022). https://doi.org/10.1038/s41372-021-01185-5

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