59 Postnatal and Cord lab Instructions

Tests to be performed on the Mom

• ABO
• Rh
• Antibody Screening (LISS)

If mom has received RhIg and has weakly reactive screening a “mini” panel may be used to investigate. This consists of:

• “rr” red cells from either the screening cells or panels available. The red cell antigens on the chosen cells must be documented on the special investigation worksheet and should include antigens for the presence of common antibodies.
• “D” positive cells

In the students lab we will perform a minimum of the following red cells with the mother’s serum/plasma

• 1 Ror cell
• 1 r’r cells
• 1 r”r cells
• 2 rr cells that are K+
• There must be at least 2 each of the following antigens in a double dose state among the D negative cells for clinically significant antibodies to be excluded: Fy(a+), Fy(b+), Jk(a+), Jk(b+), S+, s+. If the cells above do not cover all of these antigens, additional cells are required.
• 1 R1R1
• 1 R2R2

Recording Results

If all of the “D” antigen negative cells are negative with the patients’ serum and the “D” antigen positive cells are positive, it is assumed there are no other alloantibodies present along with the passive anti-D. It should be recorded as “weak anti-D demonstrable, probably passively acquired: Rh immune globulin issued on:_____________

Tests to be performed on the Cord Blood

• ABO (no reverse)
• Rh (includes weak D if mother is Rh negative)
• DAT using anti-IgG only. It is not necessary to perform the DAT on a cord using polyspcific antihuman globulin reagent because only clinically significant IgG antibodies will cross the placenta

Paperwork

• Worksheet (Post-Natal and Cord blood)
• Prenatal Card
  • Requisition
  • Does Rh Ig need to be issued?