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lab217

Pregnancy and phenotyping?

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Do any Blood Banks allow  phenotyping of pregnant patients?  Is there a timeframe defined during a pregnancy that accepts this practice? Some Laboratories phenotype and accept only negatives or strong positive reactions as conclusive. 

What does your blood bank do?

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Thank you for the fast response Malcolm Needs!  Is there any literature or publication that I can refer to?  Can't find this specifically in AABB.

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On 10/6/2017 at 2:09 PM, lab217 said:

Do any Blood Banks allow  phenotyping of pregnant patients?  Is there a timeframe defined during a pregnancy that accepts this practice? Some Laboratories phenotype and accept only negatives or strong positive reactions as conclusive. 

What does your blood bank do?

I'm assuming....yes, that gets me into trouble all the time......that you're worried about antigen suppression in pregnant women?

Antisera licensed in the USA should have been tested extensively with samples from such patients. If they were unable to correctly phenotype samples from pregnant women, it's unlikely that they would have been approved. As Malcolm points out, the only real troublemakers are the Lewis antigens.

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I've had a look at my books, and I can't see any references that say you should NOT phenotype during pregnancy.

This strongly suggests to me that there is no reason why a phenotype should not be performed during pregnancy (otherwise I am certain that it would have been mentioned, and that a reference would have been given).  Therefore, I go back to what I said earlier, that the phenotype is okay, unless there is a mixed-field reaction seen.  If a mixed-field reaction is seen, I would worry more about the health of the foetus than I would about the maternal typing, as, for a mixed-field to be seen, either the foetus has had a massive bleed, or has had a chronic bleed over a long period of the pregnancy.

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29 minutes ago, Malcolm Needs said:

If a mixed-field reaction is seen, I would worry more about the health of the foetus than I would about the maternal typing, as, for a mixed-field to be seen, either the foetus has had a massive bleed, or has had a chronic bleed over a long period of the pregnancy.

Very good point. One could argue that ALL pregnant women should be phenotyped specifically to look for mixed fields.;)

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17 hours ago, Malcolm Needs said:

The only problem with that idea exlimey is that one would only type the person once, and so you would have to be pretty lucky to coincide the typing with the foetal bleed, particularly in the case of an acute, massive bleed.

Yeah, I know. I was just being silly, pointing out that sometimes what sounds like a reasonable idea is often impractical and mostly useless.

Proposed new policy: Type them once every week for the duration.:)

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