Hello, Our facility is looking into modifying the cord blood testing procedure. Currently we perform a cord blood workup on infants born to Rh Negative and O Positive mothers. Also, if mom has a clinically significant antibody which may cause HDN. Would like to find out what others are doing. Thanks

We did virtually the same (when I was young enough to work in a hospital laboratory), but the exception was that we would perform a cord workup on babies who were group B, when the mother was group O AND from one of the Black populations.

We only do cord testing on babies of Rh negative moms

We do the same as CSP0102 unless the physician specifically orders one, usually if the baby is jaundiced the next day.

We do cord bloods on all babies with Rh neg and type O moms. And we do immune anti-A or immune anti-B testing for all type A or B babies born to type O moms - tried to make the immune anti-A/-B testing go away but we have one Family Practice doc who was adamant that we continue that test (and he was chair of the OB committee at the time). We had stopped doing cord bloods on O pos moms for several years, but resumed when the previously mentioned doc came to our facility. Trying to take the O pos mom cord bloods and immunes out of the routine order set, but leaving them as orderable tests for those who insist on having them. Work in progress there.

We do not get orders for cord bloods when mom has a clinically significant antibody unless she is Rh neg or type O. I would really like to add that.

 

We also get orders for cord workups on the babies of all O Positive and Rh negative moms -- and nothing on those moms who have been sensitized.  It would be nice to only get orders on those infants who have symptoms of HDN.

We used to perform only those cords from O mothers, Rh negative mothers, and mothers with significant antibodies. The optimal phrase is used to. We had a neonatologist that pitched a fit and went to administration, and long story short we now do ALL cord bloods.

2 hours ago, MAGNUM said:

We used to perform only those cords from O mothers, Rh negative mothers, and mothers with significant antibodies. The optimal phrase is used to. We had a neonatologist that pitched a fit and went to administration, and long story short we now do ALL cord bloods.

I feel your pain! So much for evidence based medicine

3 hours ago, MAGNUM said:

We used to perform only those cords from O mothers, Rh negative mothers, and mothers with significant antibodies. The optimal phrase is used to. We had a neonatologist that pitched a fit and went to administration, and long story short we now do ALL cord bloods.

Same here, but we only do about 400 a year and I have bigger fish to fry!

We perform CB testing on  O mothers, Rh negative mothers, and mothers with significant antibodies. Due to recent change in the policy, We are not testing AHG phase for Rh negative infants born to O pos moms since they are not potential candidates for Rhogam anyway. Also, we used to perform elutions on DAT pos cords. But, at present we wait for the physician to initiate the protocol. Saves us lots of time and resources.

we test all cords. We get ~100 to 120 cords per month...

 

We do cords from all Rh Negative moms, O moms, and moms with a clinically significant antibody or antibody of unknown significance (i.e. an autoantibody)

s

On ‎7‎/‎28‎/‎2017 at 9:05 AM, MAGNUM said:

We used to perform only those cords from O mothers, Rh negative mothers, and mothers with significant antibodies. The optimal phrase is used to. We had a neonatologist that pitched a fit and went to administration, and long story short we now do ALL cord bloods.

Just curious... how does that work in the US? Who pays for the testing on the cord blood that you would not normally have tested but now must because of that neonatologist?  Does the patient get billed?

5 hours ago, AuntiS said:

Just curious... how does that work in the US? Who pays for the testing on the cord blood that you would not normally have tested but now must because of that neonatologist?  Does the patient get billed?

Yes - and insurance company if you have insurance.

6 hours ago, AuntiS said:

Just curious... how does that work in the US? Who pays for the testing on the cord blood that you would not normally have tested but now must because of that neonatologist?  Does the patient get billed?

The patient gets billed, even though we can make the case for unnecessary testing.

We get about 800 cord samples per month.  We test all cords for Rh Neg mom's  and perform ABO/Rh and DAT (IgG) on the cord.  If mother is O pos,  we do ABO only on the cord.  If cord turns out to be other than group O a Cord DAT is reflexed.  If Mom does have a clinically significant antibody, we always perform Cord DAT.  For all other mom's, no testing.  We run all of our cord testing on Ortho Vision.

We are currently doing the same thing. We only perform cord blood testing on Rh neg moms, "O" moms and moms with any identified antibody.

Rh neg moms and those with clinically significant antibodies.  A physician may request one if they feel it's indicated for other reasons (a mom had a previously affected infant), but that's fairly uncommon.  If a baby develops jaundice, we have a separate orderable for a venous or capillary ABO/Rh/DAT

We do the same.  All group O mothers; all Rh Negative mothers; and if they had some reason to suspect a problem (i.e. a Positive DAT perhaps due to a Low Incidence Antibody that was causing the infant problems).

Brenda Hutson

Rh= and group O moms.  Also if evidence of sensitization.

 

On 7/27/2017 at 4:53 AM, BankerGirl said:

We do the same as CSP0102 unless the physician specifically orders one, usually if the baby is jaundiced the next day.

So how long do you store the cord blood?  How long are they good for refrigerated?  Do you get cord bloods on all babies?  We would like to quit performing ABO and DAT except for O moms and Rh neg moms, but have a sample as above in case the baby is jaundiced.

Thanks!

We keep our cord blood samples until we run out of storage space.  This usually works out to between 20-30 days.  We have done testing on them up to a week after delivery if the baby is jaundiced at their 1 week doctor's appointment, but that is exceedingly rare.  They almost always get ordered the day after delivery.

We have a policy to keep ours for 72 hours.  Any longer than that and we request a heel pick.

 

We have a Cord Blood Hold order that is generated by the floor and the specimen is received on that.  We keep the specimens for 10 days like all other specimens in case the doctor orders a Cord Blood Evaluation which is the Type and DAT order.

Sandy L , What tube do you use for your cord blood samples on the ORTHO Vision?  We are implementing the Vision in our BB.  Our cord bloods are currently collected in a red top tube for manual testing.  We are deciding whether to request the pink top (EDTA) as used for all other testing, or the lavender top (EDTA).