how do you handle OB titer specimens. do you just do the titer since that's what was ordered or do you also rule out additional antibodies each time...and if so, are you allowed to charge for the addl work??:confused:

Anti body ID should be performed. In our system we have option to add additional tests. Health Care is free here.

Like Mohammad in Riyadh, our health care in the UK is (nominally) free (we pay through our taxes, but to the individual, however ill they may be, the treatment is, essentially, free).

We would be crucified if we only performed a titre, without also performing an antibody investigation, each time we test a sample from a pregnant woman.

Just imagine, if a pregnant woman had an anti-D during her pregnancy, and we performed antibody levels on this anti-D, and it remained at a low level, but she also developed an anti-K (a really nasty antibody in pregnancy) and we did not detect this antibody because we did not look for it, if the baby died in utero, how a) we would feel, how the berieved parents would feel and c) how the court would deal with us ( and quite rightly so too).

We would do an antibody ID with each new sample. I don't remember any additional antibodies showing up during the pregnancy but I'm certain someone out there has. We justified the antibody ID as a need to confirm the antibody we would be titering.

:abduction

Like Mohammad in Riyadh, our health care in the UK is (nominally) free (we pay through our taxes, but to the individual, however ill they may be, the treatment is, essentially, free).

We would be crucified if we only performed a titre, without also performing an antibody investigation, each time we test a sample from a pregnant woman.

Just imagine, if a pregnant woman had an anti-D during her pregnancy, and we performed antibody levels on this anti-D, and it remained at a low level, but she also developed an anti-K (a really nasty antibody in pregnancy) and we did not detect this antibody because we did not look for it, if the baby died in utero, how a) we would feel, how the berieved parents would feel and c) how the court would deal with us ( and quite rightly so too).

----ditto---- Thanks

Free or nominally free healthcare; NOW THERE"S AN IDEA. It's a shame that in the states our politicians seem so tourn over this idea that appears to work well enough in several other countries. Don't take it for granted, free health care is what should be. Congradualtions!

Always abid on the new specimen

We receive a specimen for antibody titers about every two weeks after the 24th week of pregnancy when a clinically significant antibody is detected. Granted they MAY develope another antibody during their pregnancy but then why wouldn't you perform antibody screens on every pregnant woman with this frequency? They could become immunized as easily as the woman with a pre-existing antibody. If there are no antibodies detected initially, only Rh neg women get another antibody screen before their 28 week RhIg shot here. Of course they are all screened again if bleeding or trauma occur and then when they come in to deliver.

(I actually joined Blood Bank Talk in 2008 - just never posted. Love reading responses from Malcolm, John S. and David S. - and L106.)

Edited January 21, 201114 yr by jnadeau
added join date comment - looks like this is my first day - NOT!

Thanks for the compliment, jnadeau.

We do an antibody identification on every new specimen. As John Staley said, we charge for the Ab ID and justify it as necessary to confirm the specificity of the antibody we are titering.

Comment: We have seen new antibodies crop up during the pregnancy (although there's no way to prove whether they are truly new antibodies or preexisting antibodies of a very low titer that were stimulated to increase during the pregnancy.)

On initial ABID Titer we perform the titer in duplicate along with an ABID. With subsequent specimens we perform a Titer on the previous specimen and the one just received along with a new ABID, in essence, we always perform the Titers in duplicate along with an ABID.