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2 posts in this topic
I'm trying to find out the similarities and differences around the world (but particularly in Europe) for guidelines related to measuring fetomaternal haemorrhages and issue of anti-D.
I'm particularly interested in which countries issue anti-D and don't estimate the FMH, what formulas countries use for calculating doses, what tests different countries use, whether the FMH is measured in whole blood or packed cells, whether different countries use the 1.22 muiltiplier to account for the different sizes of red cells... Not a small list I know.
I've found a few international guidelines already so here are some useful links
UK guidelines for all Transfusion related things are here http://www.b-s-h.org.uk/guidelines/
Irish guideline on the use of Anti-D http://www.hse.ie/eng/about/Who/clinical/natclinprog/obsandgynaeprogramme/antidprevrhd.pdf
Australian guideline on the use of anti-D https://www.ranzcog.edu.au/RANZCOG_SITE/media/DOCMAN-ARCHIVE/Guidelines for the use of Rh(D) Immunoglobulin (Anti-D) (C-Obs 6) Review November 2015.pdf
Australia/New Zealand guideline on measurement of FMH https://www.anzsbt.org.au/data/documents/guidlines/ANZSBTguide_Nov02a.pdf
Canadian guideline on the use of anti-D https://sogc.org/wp-content/uploads/2013/01/133E-CPG-September2003.pdf
Please add links to this forum
Mother is O negative, baby is A negative. The DAT on the baby is positive, so the Weak D is inconclusive.
According to the limitations of the FMH screen, if you have a weak d (which we don't know if it is or isn't because of the positive DAT) you must use a test to detect feto-maternal hemorrhage other than the screen. We send out a KB for this determination. However, the limitations also state that "in cases of ABO incompatibility between mother and child, the mother's natural ABO antibodies may destroy any fetal cells in the maternal blood specimen before testing is performed. This is true for any method of detecting fetal cells in the maternal blood."
So my question is would you send this ABO incompatible specimen out for a KB or would you just issue the mother one vial of Rhogam and not worry about the KB since nothing may be detected? This was an uncomplicated vaginal delivery.