cord blood weak D testing with positive IgG

[tkakin]

I am looking at my options for testing Rh (D) negative cord blood specimens with a positive IgG.

Currently we do EGA treatment (if the cord blood is immediate spin negative and the DAT/IgG is positive), before doing the weak D testing, but that is rare...only 2 times a year, so this is very expensive to maintain reagent and training for a test performed so infrequently.

One of my concerns is that RhIG needs to be provided within 72 hours of delivery, and our reference lab is not accessible everyday.

What are other people doing in this situation?

Sending the specimen to reference lab and ordering a Fetal Screen?

Not sending the specimen to reference lab and ordering a Fetal Screen?

none/all of the above?

I appreciate all your help  Teresa

[Ensis01]

You could try 56'C heat elution method. Though this is better for IgM antibodies it usually works with IgG, but does take longer. See AABB Technical Manual Method 4.3

[Dansket]

We report the newborn to be Rh Indeterminate, with a comment that the newborn is treated as if Rh Positive for purposes of determining the mother's RhIg candidacy.  Additionally, the newborn may be tested in 4-6 months to determine the baby's true Rh type.

[Patty]

Report as Rh Indeterminate and treat as Rh+ for RHIG coverage of the Mom

[TreeMoss]

10 hours ago, Dansket said:

We report the newborn to be Rh Indeterminate, with a comment that the newborn is treated as if Rh Positive for purposes of determining the mother's RhIg candidacy.  Additionally, the newborn may be tested in 4-6 months to determine the baby's true Rh type.

We also add a comment that baby may be re-tested with no charge at the 4-6 month time.  Have not yet had anyone come in to take us up on that offer!

[tkakin]

Thank you all for your response.  I just realized I asked if you would order a fetal screen, but it should be a KLEI if they are weak D +.