Whose specimen for Neonatal Work-Up

[lalamb]

WE rarely transfuse babies. Have a current situation where mom = A pos (R1R1) and has a current and known anti little c.

Mom is being induced tomorrow - have ordered up 2 units of ag neg blood for mom, and 1 unit of O pos, little c and big E neg blood for baby, just in case. (ordered O pos as baby is expected to be Rh pos, and O neg , little c neg is rare, per ref lab).

We will crossmatch baby's unit against mom's plasma.

Our policy doesn't say how to "band the baby"...just says get a babnded specimen from the mom and crossmatch her plasma to the pedi unit. How do others link the recipient-baby to the mother?

[Sadique.Kareem]

We dont use cord blood due to many problems as mentioned by some of our collegues. but we use venous blood for typing and CxM because it gives the sense that your are working on the patient sample itself. For antibody screenig and identification if needed ofcourse we use mothers sample. But our practice is to issue O Cells irrespective of type of baby ,so we dont do Ant A and B.

[PAWHITTECAR]

I worked many years at a children's hospital and our policy was everything had to be tested on the baby. I have seen baby screens that were positive when the referring hospital swore the mom's screen was negative and babies as young as 3 months old making clinically significant antibodies that were not there as a newborn. That being said I believe that if you are going to transfuse the baby you should test the baby.

[LaraT23]

I understand the concerns of everyone as far as mislabeling goes. But, I dont think we should just assume that things will be collected improperly and change our process to deal with that. If cords are "allowed" and "assumed" to be mislabelled, what about everything else collected by nursing. We also do not transfuse babies much, but our policy states that we would do a cord type and a screen on the mom's plasma. We would then give the freshest type compatible CMV neg that was available. I am the quality officer for the lab here, so I guess the whole mislabelling thing being accepted gets me going!