CORD blood ABO/RH

[Kathyang]

I was wondering if there are hospitals that still do blood types om all CORD bloods? We are trying to change our policy to have only Rh negative mothers Cord bloods checked. We are a small hospital(100 beds) and it is hard to get the doctors to change their ways.

Any suggestions would be helpful.

Thanks,

Kathy:rolleyes:

[Mary**]

:cool:I have been in the field for 30+ years and have never worked anywhere that did Cord Blood testing on all babies.We only do those with Rh Negative moms and some on symptomatic babies who are jaundiced. Good Luck.

[BBK710]

We stopped testing ALL cord bloods 7 years ago and now routinely test only those of Rh neg. mothers. We do "hold" the cord bloods until discharge in case they suspect an ABO incompatibility in which case they can request that the cord blood be tested.

It was hard to get the docs to go along with this change and we still have one older doc that requests that all of his patients be tested because he likes to be able to tell the parents the baby's blood type.

[jdjustus]

I have worked at three hospitals and at each we have done the same as Mary.

[dmpollock]

I am in favor of only testing cord blood of Rh neg mothers. Our hospital also tests the cord blood of group O mothers, which the doctors would not give up even when given documentation that it is not necessary.

There is an ABC bulletin that states: "In a workup for anemia, there is no need to perform DATs on all infants of either Rh negative or group O mothers because the test often is positive (passive from RhoGam or anti-A, and has a very low predictive value for hemolytic disease of the newborn" Reference: http://www.americasblood.org/download/File/bulletin_v8_n3.pdf

You can see all their bulletins at http://www.americasblood.org/go.cfm?do=Page.View&pid=74

[dingalls2]

I am in favor of only testing cord blood of Rh neg mothers. Our hospital also tests the cord blood of group O mothers, which the doctors would not give up even when given documentation that it is not necessary.

There is an ABC bulletin that states: "In a workup for anemia, there is no need to perform DATs on all infants of either Rh negative or group O mothers because the test often is positive (passive from RhoGam or anti-A, and has a very low predictive value for hemolytic disease of the newborn" Reference: http://www.americasblood.org/download/File/bulletin_v8_n3.pdf

You can see all their bulletins at http://www.americasblood.org/go.cfm?do=Page.View&pid=74

I'm showing this to some of our people-we still have to do an eluate on all positive DAT's and I can tell you the outcome before I run it!!! The Docs just won't let go. I know a neighboring institution just reports out as presumptive evidence of _____.

To the OP: we do cords from all neg moms and alot of O moms. Rarely a symtomatic A or B

[dmpollock]

I got rid of the majority of the eluates, which were on cord blood from group O mothers.

In the following situation we report out "Probable ABO" incompatibilty without doing an eluate:

Mother = group O, antibody screen neg

Baby = group A or B

One rare situation where you can't figure out in advance is the case where the mother and the baby are ABO-compatible, and the mother's antibody screen is negative. This could be from an antibody against a low-frequency antigen that is present on the father's red cells. In this case the eluate would not react with your screen cells, but would be positive when tested with the father's red cells.