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Hi All, Its been a while since I came back to this forum, but glad I feel like I have gained a lot more insight. I feel like I'm a bottomless cup. So I come with a question, for which there is not going to be a definitive answer (but with BB, is there ever one?), but hopefully, I would gain a bit of understanding. Background: So, our laboratory has started sending samples to reference laboratory for genotyping of the foetus by FDNA, which is great, since we would figure out the Rh(D) status of the baby (on most occasions) before they are born! So our laboratory has set up a flow chart which basically mentions that you do not need to send cord sample of Rh(D) negative mother if the baby is shown to be Rh(D) positive (or D positive, I am quite wary when trying to talk about Rh group), and only send cord if baby of Rh(D) negative mother if the FDNA shows the baby is Rh(D) negative, just to confirm the accuracy of FDNA. It sounds kinda counterintuitive, but we will soon be just not processing any cord sample for the ones we performed FDNA on. That means no cord Blood Group or DAT on a lot of post-delivery patients. Question: By missing out DAT, we would possibly be missing out on detecting ABO incompatible HDN. How significant do you think it is in the early stages? Is it OK to wait to see if the patient shows signs of jaundice and for them to send a DCT sample afterwards? Bonus Question: What does your Hospital/Laboratory do in the event of positive DAT on cord sample, and why do you do it? I had a read through one of the articles stating about the significant of DAT, but they called the Rh blood group as Rhesus, so I'm not going to take them too seriously Cheers, Jermin
Dear All Can I pick your brain about something. Under the UK Guidelines, there is no requirement to perform a post-partum antibody screen on the mother, and no requirement to perform a DAT on the baby if the mother had no antibodies during her pregnancy (or in the past), and the mother was given routine anti-D immunoglobulin prophylaxis during her pregnancy. We are introducing RAADP in The National Maternity Hospital this year and we are wondering how did labs in the UK approach dropping the DAT on the cord. We use BioRAD 6 well ID-Cards (DiaClon ABO/D + DAT): A, B, DVI-, DVI-, ctl, DAT As we sometimes (not often) see one D well negative and the other D well positive we would prefer to stick to the 2 D well ID-card. Our problem is that we cannot source a BioRAD ID-card that has this minus the DAT well. What do BioRAD users in the UK do? Any advice would be greatly appreciated. Best wishes John