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Neonatal Type &Screen for transfusion collected from the placenta


ksmith

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Is anyone using blood collected at birth from the placenta for Neonatal Type & Screen and transfusion?

Our facility is looking at doing this for initial labs and they want to include the Neonatal Type & Screen which could be used for transfusion. 

If you are using this, are there any special considerations you made when implementing this process?

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They are drawing from the baby side of the placenta from the fetal vessel. 

I’ve not decided if I consider this any different from the cord blood. When I said it must come directly from the patient, they said it does.

I think since there is nothing written definitively stating this type of sample is not acceptable for pretransfusion, they are just looking for a way to not take blood directly from the baby.

I’ve asked for info to contact other facilities with this practice, but haven’t gotten anything yet  

They are just beginning to look at this process, so we’ll see how it goes.  

 

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3 hours ago, John C. Staley said:

I'm confused here.  Isn't placental blood mom's blood?  I guess it depends on which side you get it but then the other side is cord blood so why would anyone want to use placental blood for pretransfusion testing?  What am I missing here?  :confuse:

The same things I am I bet.

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They do this occasionally at our facility.  The specimen(s) are labeled at the time of collection with a label made by scanning the infant's identification band.  We also do not use cord blood specimens for crossmatching/transfusion purposes.  This source is also often used for chromosome testing due to the larger volume that is needed.  They will not use placental blood when twins are delivered.

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We use cord blood specimens for pretransfusion testing for some very small birth weight babies.  We ran a validation to show that the results matched the peripheral blood specimens we were getting.  As long as the people collecting them know where to draw it from to get baby's blood, you should be fine.  We also give only O, Rh matched blood to our neonatal patients, so it's not as high risk as some on this thread make it seem. 

One item to watch out for if you do proceed with this:  occasionally we'll see a mixed field result in the ABO/Rh. If we do, then we confirm the blood type using a peripheral blood sample. 

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23 minutes ago, ksmith said:

TreeMoss - Do you know if CBCs are run from placenta blood at your facility?  If so, could we reach out to your facility to talk to them?  Thanks.

FYI - at our facility, we tried to validate CBCs from cord blood specimens, but the values were quite variable when compared to peripheral blood. 

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