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gagpinks

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Everything posted by gagpinks

  1. Hi all Today i have seen another interesting case in my 15 years career. Some of you might already have seen. Mum A Rh D Pos. Antibody screen negative , baby's DAT negative , xmatch found to be compatible with baby red cell and mum plasma. No sigh of haemolysis , bilirubin normal only baby's Hb is 70g/l . Result phoned to clinician and they requested FMH test . Kleihauer test is positive and approximately look 70-80 ml bleed. Is there any technique or test to confirm this large FMH in case of Rh positive mum ? Do we have to think anything else in terms of transfusion side.?
  2. What else could it be ?
  3. Last time patient was transfused was 6 month ago. Reference lab suggested this could be due to Matuhasu-ogata phenomenon. Would please explain this phenomenon.
  4. Hi Patient has Known Anti-K. Since than patient been transfused with K neg unit. Current sample shows Anti-K with positive DAT. Sample sent reference lab for eluate. Anti-K detected from eluate.If patient given K neg blood why would Anti-K still be detected from eluate?
  5. Now it make sense but in uk we don't perform weak D typing on cord sample. What method do you use to perform your blood group? We use gel technology to perform blood group on cord sample unless weak reaction with anti-D
  6. If baby is Rh Negative why do need to perform FMH test. In this case, do you think positive DAT could be due to ABO incompatible or antibody against low frequency antigen? Or something I am not aware of. It might be silly question but why would you perform weak D typing if baby is Rh neg.
  7. In UK now we have 2 sample policy. If you don't have 2 valid sample give O Red cell and AB plasma and A neg platelet until second sample is available. We don't retype same sample just in case ,it is Wrong blood in tube. Same criteria for EXM: 2 valid sample processed on analyser (both forward and reverse grouping )without manual editing with negative antibody screen.
  8. I enjoyed reading it. Thank you Blut! ! UK is lucky to have him with his wealth of knowledge and he is always on board to reply any time.
  9. How do we manage the patient with CHAD especially with very low Hb?
  10. How about using incubator? That will cover guidelines as well as solve the problem.
  11. I agree with you MaryPDX!!! There was couple of times we got false negative DAT due to the technique we use. If you are using Gel DAT I would prefer to use analyser be cause transfused cell are at the bottom. But if you are using manual technique probably you can use whole blood but that will clash with manufacturer instructions.
  12. I wish same . But I'm sure Malcolm will send us presentations.
  13. Thanks Malcolm and exlimey.!!!! This is what our consultants suggested. Patient is stable now. Could you please explain bit more about anti ce.
  14. Patient pre transfusion antibody screen was negative but DAT is positive IgG 2+. Pre transfusion Hb was 74 g/l. After transfusion Patient bilirubin went up to 230 and Hb drop to 60 g/l so clinician suspected transfusion reaction. Post transfusion sample : antibody screen positive and found to auto anti -e because auto control is positive and Patient is rrK-. Sample sent to reference lab for eluate and reported as auto anti e. DAT positive Ig G 3+ and C3d 3+. Few hours later patient haemoglobin drop to 39 g/l. No underlying bleeding in this patient. Can auto anti-e cause this severe transfusion reaction or could be something else. Concerns was raised to reference lab and they suggested patient could be e varient . I was suspecting it could be anti Ce. How would you differentiate anti e from anti Ce ? Still waiting for reference lab report.
  15. We had a smilliar scenario and the explaination is transfused cells are dense so upon centrifugation transfused cells settle at the bottom and analyser's probe aspirate from bottom. And it's differ from manual technique .
  16. Hi all, We recently received booking blood (10 weeks) sample from antenatal clinic. This is her second pregnancy and woman arrived from eastern Europe Where her antibody identification look like anti- C+D. Therefore sample sent to reference lab for quantification and her antiD level is 16.1 Iu/ml and Anti-G titre is 4. In terms of repeat sample reference lab advice us not to send any further sample but patient should be refer to FMC unit. I would be interested if anyone know how would they manage this fetus? Apart from IUT is there any other therapy?
  17. Hi Tricia Thank you for help. Just wondering, can I use this ( discussion forum ) as an example to write my reflective statement where I communicate finding to specialist and other professional group
  18. Agree with you. We have set up criteria for EXM where it will only allow us to perform if there is no previous antibody screen positive and also current antibody screen MUST be negative regardless of clinical significant.
  19. gagpinks

    AntiD

    Hi Malcolm just wondering what is advisable in terms of follow up care for those neonates born to mothers with antibodies with the potential to cause HDFN. Some of these babies are born well but may deteriorate later. How long should we be concerned about haemolysis persisting post nataly for example with anti-D or anti-c. Also should we be less concerned with neonates born to mothers with a lower quantification? We are advised by RCI that pregnancy should not continue beyond term but this seems to be at odds with what is advised in BCSH and RCOG guidelines which advise that these babies should be delivered at 37 weeks.
  20. gagpinks

    AntiD

    Hi Sorry for late reply. Patient has known for placenta acreta so we are not sure the reason for c-section. (due to clinical condition or rising antibody level) Baby's DAT is positive (obviously ) and Hb is 175 g/L and bilirubin is elevated to 89 umol/L . Baby is on phototherapy, no blood required so far. Thanks
  21. gagpinks

    AntiD

    Hi Malcolm The woman has delivered the baby at 35 weeks by planned C section. Her final quantification level is 6.1 iu/ml.
  22. gagpinks

    AntiD

    My point here is that we could have easily missed out this case if we would have not Noticed the strength of reactions because her antibody screen was negative at 28 weeks so proph D was given as a routine RADDP at 28 weeks. But when she came at 32 weeks her antibody screen was strong positive .
  23. If antibody screen is positive and if we have upto date record of prophylaxis anti-D than we report as AntiD detected due to prophylaxis or sensitizing event. Please check history and confirm with clinician. BUT If patient has sensitizing event prior to 28 weeks we treat as immune antiD and send sample for quantification and continue antenatal and postnatal prophylaxis.
  24. Lady had delivered the baby and Hb was 198g/dl and required triple phototherapy. Baby is well and now has been discharged.
  25. gagpinks

    AntiD

    Sure Malcolm I will! ! Malcolm and little lab my point here is that we could have easily missed out this case if we would have not checked the strength of reactions because her antibody screen was negative at 28 weeks and proph D was given 4 weeks ago. This was my special interest so I have performed in house titre which was 1: 512 so when we got result back from ref lab we were not convinced and so we sendt second sample for confirmation and where we got 4.1 iu/ml. I don't know whether you have seen my previous post where I asked USA friends what is the correlation between titre and quantification.?
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