Processing cord blood samples

[JWALKER]

Hello all.

Our entire hospital at RGH are setting up patient safety goals for this coming year, and each department has to come up with 2-3. One idea we came up with is to have a definitive way to identify moms with their babies in the Blood Bank. As a routine situation in the blood bank, we base what tests we do for newborns on the mom's Abo/Rh. Currently, when we receive a cord blood into the blood bank, our babies come down with, for example- stevens, m-ch victoria. We then look up the patient, Stevens,Victoria in our hospital census, and then match that patient up in SafeTrace TX, and then attach the mom to the baby in SafeTrace TX. As a benchmarking process, I would like to know if others here identify moms in different ways. Any comments would be greatly appreciated. Thank You.

[lalamb]

Our cord bloods come to the lab labeled w/ mom's name and type, gender, date and time of delivery and Dr's name. OB orders an ABO/DAT panel for the baby.

We check the mom's type in the LIS (sometimes the clinincs send over records that don't match our record for aborh) and work up the cords, if warrented. Any testing not warrented is canceled as "Test Contraindicated"

All cords (babies) have a note put in their BB history file which states the mom's 1st name, her med red #, and the mom's type.ie Mom (Jane 123456) is A pos. This is entered for all cords, whether they are worked up or not.

[David Saikin]

Our cords come labeled with the MOM's label, the child's gender, date/time of collection and labeled as cord blood. The order for any work done on the cord sample comes with an attachment containing the mother's mr#.

[rravkin@aol.com]

Just curious; How old are your cord blood specimens when received, on average? Do you have any policy specifics associated with the age of the cord blood?

[lalamb]

Our cords are usually less than 10 hours old, depending on when OB sends them to the lab. Ave is ?6-8 hours old

We have no time/ age specification

[jwilb]

Cord bloods are often 4-6 hours old before getting to our BB. Which raises the question of mothers who need a fetal bleed screen. The package insert says test the mother at least one hour after delivery but as soon as possible after that. At 10 or more hours is the fetal bleed screen less sensitive or even invalid?

[David Saikin]

We routinely draw our fetal bleed screens with the next blood draw, usually a post-delivery H&H. Some feel that ABO incompatible fetal cells will be removed prior to sampling . . . I haven't seen a mother sensitized post-delivery in decades / and that is NOT obtaining a FBS specimen ASAP.

[John C. Staley]

One other thing to consider is how your facility handles adoptions. Depending on the circumstances they may go to great lengths to prevent any connection between mother and baby records. While this may be a rare occurence, if it is possible, you may need a way to deal with it in your SOP.

You know how stubborn blood bankers can be in following the SOP to the letter.

[Malcolm Needs ☆]

I'm certain I remember something like this coming up in another, older thread (which probably means that it has never, ever been discussed before, knowing my memory!), but there is a danger that foetal red cells that enter the maternal circulation are, for a time, sequestered in the maternal spleen if there is too long a wait between birth and the drawing of the maternal blood sample, if the foeto-maternal haemorrhage actually happens during the birth itself.

[jwilb]

Yes, there was an older thread along these lines. The gist was time limits for FBS after delivery. I always thought the package insert trumped AABB, FDA or any other source.

[Mary**]

I agree with you David.