Any thoughts on anti-mur? I have a patient that's delivering with it, and there isn't much in the technical manual concerning it. 

Thanks

Anti-Mur has caused  severe HDFN.

 

It would definitely be worthwhile seeing if the father is Mur+ (particularly if he comes from the Far East, where the Mur antigen is found more frequently), and having the fetus scaned by MCA Doppler (although this is not particularly predictive near labour).

 

The good news is that, should the baby be affected and require an exchange or top-up transfusion, most of the units in your bank will be Mur-.

 

In which country do you work RaeRae51, because my last statement may be untrue if you work in the Far East?

I'm in the US, in Northern California.  We have a very large Asian community.

Well, in that case, IF the baby requires an exchange or top-up transfusion, you shouldn't have any problems finding suitable blood.

Im assuming, crossmatch compatible is acceptable?

Unless your blood supplier has an anti-Mur that is strong, I would have thought that the anti-Mur in your pregnant lady is as good a reagent as any available!

 

Yep, I'd go for cross-match compatible.

There is no reaction of any sort for us, the doctors informed us of the antibody.  I ran some panels to see if there were any reactions but all were negative.

Well, with all due respect to you, I am not in the least surprised at that.

 

The chances are that your screening cells and the cells in your antibody identification panel are derived from White donors, with possibly a few Black donors, but no donors from the Far East, and so, as the frequency of Mur+ in the White and Black populations are, give or take, <0.1% (and probably a lot less than that), so I wouldn't expect you to be able to detect this specificity.  Sadly though, that does not make it any less clinically significant, so BE CAREFUL!

Yea I figured as much, because I didn't see anything with the extended typings on the panels.  I more did it out of curiosity. 

Thanks for your help Malcom, you are like a walking technical manual, its great!

My pleasure; it's my hobby, for which I get paid - but PLEASE don't tell my employers, or else they may STOP paying me!