CORD DAT post RAADP

[Johnquigley]

Dear All

 

Can I pick your brain about something.

 

Under the UK Guidelines, there is no requirement to perform a post-partum antibody screen on the mother, and no requirement to perform a DAT on the baby if the mother had no antibodies during her pregnancy (or in the past), and the mother was given routine anti-D immunoglobulin prophylaxis during her pregnancy.

 

We are introducing RAADP in The National Maternity Hospital this year and we are wondering how did labs in the UK approach dropping the DAT on the cord.

 

We use BioRAD 6 well ID-Cards (DiaClon ABO/D + DAT): A, B, DVI-, DVI-, ctl, DAT

 

As we sometimes (not often) see one D well negative and the other D well positive we would prefer to stick to the 2 D well ID-card. Our problem is that we cannot source a BioRAD ID-card that has this minus the DAT well.

 

What do BioRAD users in the UK do? Any advice would be greatly appreciated.

 

Best wishes

 

John

Edited March 9, 2015 by Johnquigley

[pstruik]

Not at all helpful to your particular problem I am afraid but in preparation for introducing our RAADP programme we stopped routinely performing DATs on cord samples from babies born to mothers without antibodies about 6 months before we started.

 

I awaited the outpourings of grief and woe, the wailings and the gnashings of teeth from our midwives and paediatricians.

And it never came.

 

In fact when I asked at my transfusion training sessions up to a year later it was almost universally believed that we performed a group and DAT on every cord sample.

Which gives a clue as to how much notice was taken of our lovingly crafted reports.

 

Good luck with finding a solution to your problem.

Edited March 11, 2015 by pstruik

[YorkshireExile]

We are not in the UK, but apart from mothers with antibodies we only do grouping and DAT on babies whose mother is group O or any group Rh negative.  Interesting on your choice of Biorad card. We use a Biorad newborn card that only has one anti-D well but has an anti-AB well, as sometime we get very weak reactions with the anti-A and/or anti-B and we use the anti-AB as confirmation.

 

Is using two types of anti-D common for grouping babies (and adults for that matter)?

 

John - what do you do next when you have a grouping result with one anti-D well negative and one anti-D well positive?

Edited March 11, 2015 by BoroCliff

[aafrin]

Are both the anti-Ds "DVI-" in the card you are using?

Again - how do you interpret when one well shows neg reaction and other positive?

[galvania]

You could use the 5048 card.  It has A-B-AB-D-D-ctl.  The only thing is that one of the two Ds does detect DVI, the other doesn't.  It is, of course monoclonal.

[Auntie-D]

Everywhere I have worked we have done them and very, very rarely find one that is positive.

 

I'm wondering if, now we are using 1500s as there are no 250s and 500s, that we will see more positive ones at delivery...