Newcastle Laboratories

Antenatal & Postnatal Suitability

Clinical Background:

Request Reason:Prevention of Haemolytic Disease of the Fetus and Newborn (HDFN) in RhD Negative women to reduce the chances of forming immune anti-D antibodies (i.e. becoming sensitised). • Anti-D ...

Request Reason:Prevention of Haemolytic Disease of the Fetus and Newborn (HDFN) in RhD Negative women to reduce the chances of forming immune anti-D antibodies (i.e. becoming sensitised). • Anti-D immunoglobulin prophylaxis is given routinely at 28-30 weeks gestation • Within 72 hours following any sensitising events (an incident in which a fetomaternal haemorrhage may have occurred) • Within 72 hours on delivery of an RhD Positive baby. Possible sensitising events:- • Amniocentesis, chorionic villus biopsy and cordocentesis • Antepartum haemorrhage/Uterine (PV) bleeding in pregnancy • External cephalic version • Abdominal trauma (sharp/blunt, open/closed) • Ectopic pregnancy • Evacuation of molar pregnancy • Intrauterine death and stillbirth • In-utero therapeutic interventions (transfusion, surgery, insertion of shunts, laser) • Miscarriage, threatened miscarriage • Therapeutic termination of pregnancy • Delivery – normal, instrumental or Caesarean section • Intra-operative cell salvage

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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:

    6mL K2 EDTA (Pink Top)

    6mL K2 EDTA (Pink Top)

  • Minimum Volume Adult:

    6mL

    6mL

  • Minimum Volume Paediatric:

    2mL

    2mL

  • 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:

    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)

    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)

  • Interpretation:

    SUITABLE to receive prophylactic Anti-D injection: Mother is RhD Negative and DOES NOT have immune anti-D in her plasma after delivery of an RhD POSITIVE baby. Routine antenatal and postnatal proph...

    SUITABLE to receive prophylactic Anti-D injection: Mother is RhD Negative and DOES NOT have immune anti-D in her plasma after delivery of an RhD POSITIVE baby. Routine antenatal and postnatal prophylactic anti-D should always be given irrespective of additional anti-D immunoglobulin that may have been given due to a previous sensitising event. FMH is performed to determine if any ADDITIONAL doses of anti-D prophylaxis are required; 1500IU Anti-D i.m is sufficient for up to 12mL FMH.

    NOT SUITABLE to receive prophylactic Anti-D injection: Mother is RhD positive Mother is RhD negative with known immune anti-D in her plasma after delivery of an RhD negative baby

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  • Factors Affecting Result:

    Anti-D Immunoglobulin is not indicated: • If the woman declines, after discussion of the benefits and risks. • If the woman is in labour. • Patients known to be sensitive of Anti-D immunoglobulin o...

    Anti-D Immunoglobulin is not indicated: • If the woman declines, after discussion of the benefits and risks. • If the woman is in labour. • Patients known to be sensitive of Anti-D immunoglobulin or any of the products ingredients. • Rh D Positive women. • Women who are identified as previously sensitised i.e. have anti-D antibodies. Please refer to antenatal clinic guidelines for management in this situation For Suitability specimens: Insufficient,clotted or haemolysed specimens. Detection of previous prophylactic anti-D injections or other maternal atypical antibodies will require investigation and may extend turnaround times.

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  • Referenced Documents:

    4/1/15

    4/1/15

  • Other Info:

    Rhophylac anti-D Injections must be kept refrigerated at 4-6oC.

    Rhophylac anti-D Injections must be kept refrigerated at 4-6oC.

  • 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:

    Yes

    Yes

  • Specialist Contact Name:

    transfusion manager

    transfusion manager

  • Specialist Telephone:

    0192 213 9169

    0192 213 9169

Availability:

Routine hours only for antenatal prophylaxis. Sensitising Event prophylaxis available all times at RVI Suitability results and postnatal prophylaxis. Samples may be sent to RVI laboratory at all times. (if received after 5pm, Suitability Results and injections will be available by the following morning).

Turn Around:

Sensitising events: Issue of primary anti-D injection with 2 hour. Issue of subsequent anti-D injection is required within 24 hours Suitability and post natal Anti-D injection: From 08:30 -20:00:- 6 hours (Subject to the detection of an alloantibody or previous prophylaxis injection.) From 20:00 -08:30:- Available by the end for the following morning. Routine prophylaxis: By the date documented on the request form.

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