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Testing algorithm for post-delivery cord blood?
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4/7/2016 at 5:21:24 AM GMT
Posts: 9
Testing algorithm for post-delivery cord blood?

A transfusion service asks:

 

What are the policies of your blood bank with regard to post-delivery maternal samples submitted to assess a need for more than one vial of RhIg to prevent alloimmunization:

1) In the case that the baby's blood type is unknown (e.g. a miscarriage). In these cases, does your lab use the fetal bleed screen (rosette test) or is the test in this instance considered invalid and you proceed straight to a Kleihauer-Betke (KB)?

2) In the case of maternal/fetal ABO incompatibility and a weakly positive cord DAT. In these cases, does your lab use the fetal bleed screen (rosette test) or is the fetal screen test considered invalid and the techs then proceed straight to KB?


I am looking at our SOPs and wondering if there are situations where the rosette test is not considered valid by other institutions based on the test results on the cord blood or the unavailability of those results (such as in the case of fetal demise).

 

 



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4/15/2016 at 4:20:05 PM GMT
Posts: 9
From the CBBS Editors

At our institution, we would issue one dose of RhIG and then perform KB testing in the following scenarios (fetal bleed screen results would be considered invalid and not reported if performed or skipped all together):
1. Baby’s Rh type is unknown (due to recent IUT, baby sample or type not available due to fetal demise or other reasons)
2. Fetal bleed screen strongly positive (most likely due to mother being RhD variant)
3. Baby with positive DAT (weak D testing is invalid, and we do NOT perform EGA* treatment on these samples)
4. Baby with positive weak D test (Fetal bleed screen may be false negative)

*EDTA glycine acid


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