Is anyone using or thought about using the Fetal Screen Kit for FMH (kit by Immucor) to detect D antigen on infant red cells with a Positive DAT? This would be a direct test on the baby cells (not using mom's specimen at all). It would be an alternative to Du testing by AHG. There is no modification of the procedure. The baby cells are just not in the mom when you test them. The Positive DAT does not seem to interfere by the testing we have performed. Cord blood testing is the situation where this use would be most applicable. Any thoughts on this?

You would still have to take the cells through to ahg phase would you not? It is only a chemically modified anti-D, not an IgM. Aside from the fact that the pkg insert says the D cannot be used for typing purposes . . .

You are not really "typing" the cells for D antigen. You are using the same principle of D antigen detection stated in the procedure. You are simply testing a specimen to see if D antigen is detected just as you are doing when testing the Mom's cells. If the screen is negative, would that not mean "D antigen is not detected" in the mixture of cells that was tested" and that would be the test interpretation. As for the AHG phase for the weak D type, with so many Rh typing products out there on the market, Rh types vary among the labs depending on which product you use. Thanks for your input. this is what I am looking for. Points I may not have considered.

YOu would lose in a lawsuit!

we are redoing our cord policy---I have learned a few thing--hope I have it straight......any input would be greatly appreciated, esp a Cord Blood Workup Flow Chart!!!!

If baby is weak D pos:

1. fetal screen testing shouldn't be performed and mom should have a KB (weak D pos may give a false neg fetal screen and if fetal screen is pos, you need a KB anyway) ,
   
2. and a DAT must be performed to rule out a false pos Weak D (agglutination seen could be caused by a weak D or a pos DAT, can't tell which)
   

so, if cord = Weak D pos:

1. cancel fetal screen on mother and order a KB
   
2. mother gets 1 dose of rhogam
   
3. do DAT
   
4. if DAT is pos,
   

• contact provider
  
• mothers specimens get a KB
  

1. if DAT is neg
   

• mothers specimen gets a KB
  

If weak D is positive dosing of Rhig is determined by KB or other quantitative method for determining the size of the fetal maternal bleed