Antigen typing during pregnancy

[Jsbneg]

Hi everyone,

Please forgive my ignorance regarding this question, but I'm still confused about why antigen typing (as part of antibody workups) cannot be reported within the last three months of pregnancy, at least according to the practice in the blood bank where I currently work. I'm assuming this is to prevent mistyping in cases of a fetal-maternal hemorrhage. I'm curious if this is a common practice in other places and if there are any AABB or CAP regulations addressing this issue.

Thank you in advance.

[John C. Staley]

I've never heard of that.  While I can understand the rationale, I'm afraid that if there was enough of a fetal bleed to impact antigen testing mom there are bigger problems than just getting the antigen type right.  Just my thoughts.

 

[Bet'naSBB]

I've been Blood Banking for 35 years......... (albeit in the same hospital) but I've never heard of that - nor do I know of any AABB or CAP regs that would imply that...... (and we've just been inspected by both!)

[Neil Blumberg]

Not a sensible approach in my opinion.  No real chance of mistyping due to fetal bleed.  At very least, you'd see a mixed field if there were a fetal bleed with a different type.  So get rid of this requirement in my view.

[exlimey]

Concur with the above. It would have be a very serious F-M bleed to impact phenotyping. While there is a theoretical risk of mixed field, and potentially spurious interpretation of the results, if a gravid patient develops an antibody that late in the gestation, the very small risk of mistyping/reporting is worth taking.

[Jsbneg]

Thank you all very much for your responses. I'm glad to hear that this is not a common practice and I do agree that the risk of mistyping would be extremely rare. This was my first time as well seeing this kind of practice.  Definitely worth an SOP change.