Jump to content
PathLabTalk

Solid Phase reactions in Newborn with no Maternal history


acrolabgeek
 Share

Recommended Posts

Newborn: full term, resp distress post meconium aspiration- solid phase aby screen is positive and antibody id is positive across the board. tube dat/auto control are negative. requested a second sample and had same results.

negative maternal history- aside from RhIg rec'd 4 months prior. same blood type as baby.

any ideas for reactivity?

Link to comment
Share on other sites

Why are you antibody screening newborns out of curiosity? A cord sample for a group and a maternal sample for antibody screen is recommended, but only if the baby is for transfusion. There is no need to antibody screen a newborn as you are effectively just testing the mother...

As for why the baby shows it but the mother doesn't? The Placenta actively transports antibodies across resulting in a (usually) higher titre in the baby than the mother. Maybe the mother does have the antibody but in too low a titre to be detected.

Link to comment
Share on other sites

Hi Auntie-D

Sometimes mom's sample is not available and it is perfectly acceptable to perform screen on baby's sample even if mom is around.

JB

Why are you antibody screening newborns out of curiosity? A cord sample for a group and a maternal sample for antibody screen is recommended, but only if the baby is for transfusion. There is no need to antibody screen a newborn as you are effectively just testing the mother...

As for why the baby shows it but the mother doesn't? The Placenta actively transports antibodies across resulting in a (usually) higher titre in the baby than the mother. Maybe the mother does have the antibody but in too low a titre to be detected.

Link to comment
Share on other sites

  • 2 weeks later...
Hi Auntie-D

Sometimes mom's sample is not available and it is perfectly acceptable to perform screen on baby's sample even if mom is around.

JB

What I meant though was there is no requirement to do a back type or antibody screen on a neonate unless for transfusion - it is a pointless excercise...

Link to comment
Share on other sites

There have been reports of positive Capture-R Ready Screen and Read-ID reactions (positive in all wells) due to antibody binding to cryptic RBC membrane antigens exposed in the RBC membrane drying process and to components in the Capture-LISS dye component) reagent. What to IAT in tube or gel indicate? These Capture problems do not occur in the other test procedures, and while rare, should be considered a limitation due to the time and effeort needed to resolve the problem. Were all screen/ID test wells the same reaction strength, and how strong were the reactions?

Link to comment
Share on other sites

Having worked with Solid phase long enough I would first suspect junk reactivity and test in the tube with LISS. If that is negative I'd call this a negative screen. If you get something there then it's possible that what someone above suggested - the titer in the mother is just too low to detect and you are picking something up in the infant.

Link to comment
Share on other sites

I would be interested in finding out what your final conclusions were. Sounded like junk reactivity maybe due to the infection. Were tube reactions neg? We also use baby's sample routinely for newborn type and crossmatch even if Mom is available. Only use mom if more sample is needed for antibody ID then what one can get from a newborn (usually a tiny preemie in the NICU).

Link to comment
Share on other sites

We also use baby's sample routinely for newborn type and crossmatch even if Mom is available.

Poor baby :( Why put the poor mite through the trauma if you don't need to? We take a cord sample at birth then crossmatch against a maternal sample if crossmatch is needed. I will add again that a newborn antibody screen/crossmatch is not required at birth as all the antibodies are maternal...

Also you are more likely to get a decent sample from the mother, than a traumatic heel-*****. Which, I would like to add, saves events from happening like the OP described.

Link to comment
Share on other sites

Poor baby :( Why put the poor mite through the trauma if you don't need to? We take a cord sample at birth then crossmatch against a maternal sample if crossmatch is needed. I will add again that a newborn antibody screen/crossmatch is not required at birth as all the antibodies are maternal...

Also you are more likely to get a decent sample from the mother, than a traumatic heel-*****. Which, I would like to add, saves events from happening like the OP described.

These generally are not heel sticks but are drawn from a line. We do not crossmatch the infant, only a type and screen until 4 months old. Then reserve a unit and its good until it outdates. I think it probably started that way at this facility because so many babies in our NICU are referrals. We use gel and really do not use very much sample to do the TSG. This was also pretty much the same way we handled it when I worked in Boston.

Link to comment
Share on other sites

heel-*****.

Sorry to "hijack" this thread, as it were, but is it just me, or do these automatic "*****"s draw attention to a word with a double meaning, when only the "clean" meaning was meant? In other words, they emphasise the double meaning, rather than "dilute" it, thus defeating the object in the first place.

:angered::angered::angered::angered::angered:

Link to comment
Share on other sites

Create an account or sign in to comment

You need to be a member in order to leave a comment

Create an account

Sign up for a new account in our community. It's easy!

Register a new account

Sign in

Already have an account? Sign in here.

Sign In Now
 Share

  • Advertisement

×
×
  • Create New...

Important Information

We have placed cookies on your device to help make this website better. You can adjust your cookie settings, otherwise we'll assume you're okay to continue.