Newcastle Laboratories

Antenatal Group and Save

Clinical Background:

Request Reason: Antenatal, pregnancy. Pregnant women are offered a blood group and antibody screen early in pregnancy as part of routine antenatal booking (usually 10-12 weeks gestation) and again ...

Request Reason: Antenatal, pregnancy. Pregnant women are offered a blood group and antibody screen early in pregnancy as part of routine antenatal booking (usually 10-12 weeks gestation) and again at 28 weeks gestation. This identifies women whose babies are at risk of developing Haemolytic Disease of the Fetus and Newborn (HDFN) due to developing antibodies or previously having antibodies from a previous pregnancies/transfusion. RhD Negative women are offered routine antenatal anti-D prophylaxis (RAADP) at 28 weeks gestation, after any sensitising event and post natal following delivery of an RhD Positive baby. This helps to prevent the development of immune Anti-D which can affect future pregnancies. Women with any clinically significant red cell antibodies should be referred to a specialist centre and seen under the care of a consultant obstetrician. They will be monitored more closely and have regular samples referred to a reference laboratory for antibody quantitation. In the case of anti-D and anti-c (which are the antibodies most likely to cause significant HDFN) antibody quantitation is recommended every 4 weeks until 28 weeks then every 2 weeks until delivery. Paternal testing may be required if a clinically significant antibody are identified during pregnancy. A group and save specimen will be requested for paternal phenotype testing to determine the % risk for the baby to have the corresponding red cell antigen. If the father is not able to be tested then fetal testing can be undertaken at the International Blood Group Reference Laboratory (IBGRL) in Bristol if considered clinically necessary. Identification of the ABO group and antibodies in pregnancy also allows the transfusion laboratory to provide suitable blood prior to labour, for delivery or any other intervention.

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Test Details

  • Discipline:

    Transfusion

    Transfusion

  • Specimen Container Adult:

    6mL K2 EDTA (Pink Top)

    6mL K2 EDTA (Pink Top)

  • Specimen Container Paediatric:

    N/A

    N/A

  • Minimum Volume Adult:

    6mL

    6mL

  • Minimum Volume Paediatric:

    N/A

    N/A

  • Special Requirement:

    Sample must be HANDWRITTEN and contain the patient's details

    Sample must be HANDWRITTEN and contain the patient's details

  • Sample Stability:

    Short term storage: 24 hours at Room Temperature. Long term storage: 7 days at 4-6

    Short term storage: 24 hours at Room Temperature. Long term storage: 7 days at 4-6

  • Transport Requirements:

    Sample should be transported to Laboratory Medicine Reception via GP courier, hospital air-tube system or hand delivered to maintain storage conditions. Samples must not be subjected to extreme hot...

    Sample should be transported to Laboratory Medicine Reception via GP courier, hospital air-tube system or hand delivered to maintain storage conditions. Samples must not be subjected to extreme hot or cold conditions prior to testing.

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  • Add On Test:

    Requested as required by the laboratory. DAT Eluate, Antibody Investigation, Antibody quantitation referral, Maternal Phenotype, Paternal phenotype. Requested as required by the Patients clinical d...

    Requested as required by the laboratory. DAT Eluate, Antibody Investigation, Antibody quantitation referral, Maternal Phenotype, Paternal phenotype. Requested as required by the Patients clinical details. Blood Product issue, Anti-D injection issue.

    All urgent add ons via telephone must be confirmed via email to the appropriate email address

    RVIadditions.Laboratory@nuth.nhs.uk (internal)

    tnu-tr.bloodsciencesadditions@nhs.net (external)

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  • Interpretation:

    The presence or absence of antigens and antibodies is identified by agglutination. Agglutination occurs when the red cells are cross-linked by the binding of either IgG or IgM antibody molecules. T...

    The presence or absence of antigens and antibodies is identified by agglutination. Agglutination occurs when the red cells are cross-linked by the binding of either IgG or IgM antibody molecules. The pattern of reactions against a panel of reagents with known antigen or antibody status is used to identify the antibodies or antigens present. The report will state the patient's Blood Group and indicate whether alloantibodies are present or not. The samples may require referral to an NHSBT reference laboratory depending on the clinical significance of any antibody detected in pregnancy. Once the investigation to identify clinically significant allo and/or auto antibodies is complete the laboratory can provide compatible antigen negative blood for transfusion or issue prophylactic anti-D where applicable. Routine antenatal anti-D prophylaxis is at 28 weeks gestation.

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  • Factors Affecting Result:

    Key factors affecting the result: • Incorrect specimen type received • Clotted, haemolysed, icteric or lipaemic samples • Insufficient plasma provided • Clotted samples may interfere with instrumen...

    Key factors affecting the result: • Incorrect specimen type received • Clotted, haemolysed, icteric or lipaemic samples • Insufficient plasma provided • Clotted samples may interfere with instrument pipetting and must not be used. • Fibrin or particulate matter, clots, bubbles or scratches can interfere with reaction interpretations.

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  • Referenced Documents:

    4/27/15

    4/27/15

  • Routine Contact Name:

    Section Leader:

  • Routine Telephone:

    Freeman: 0191 213 7849
    RVI: 0191 282 43435

    Freeman: 0191 213 7849
    RVI: 0191 282 43435

  • Specialist Test:

    No

    No

  • Specialist Contact Name:

    transfusion manager

    transfusion manager

  • Specialist Telephone:

    0192 213 9169

    0192 213 9169

Availability:

Routine core hours Only

Turn Around:

24 Hours If Antibody quantitation required (NHSBT Referral): 72 hours from receipt in the reference lab

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