IBTS DIAG GDE 0001 - Irish Blood Transfusion Service

More documents

Recommendations

Info

IBTS/DIAG/GDE/0001 Ver. 2 Page 35 of 4112.0 GUIDELINES: MEDICAL/SCIENTIFIC12.1 Antenatal GuidelinesAnte Natal SpecimensIt is the policy of the IBTS Diagnostics Laboratories to follow the “Guidelines for BloodGrouping and Antibody Testing in Pregnancy (British Committee for Standards inhaematology) 2006” which includes the timing of Ante-Natal sampling for patients withand without Red Cell Antibodies12.1.1. Specimens for Quantitation (Anti-D and Anti c).The Biological Reference Ranges for Patients with Anti-D and Anti c are as follows,Anti-D levelIU/mlRisk ofHDNRecommendation0 – 4 Low risk Repeat specimens recommended every 4weeks to week 28 gestation, then every 2weeks to delivery.4 – 15 Moderate Recommend referral to a specialist FoetalRisk Medicine Assessment Unit. Repeat specimensrecommended every 4 weeks to week 28gestation, then every 2 weeks to delivery.Note: Subsequent referral for Anti-Dquantitation is of limited clinical value once> 15 HighRiskFoetal Medicine Assessment has commenced.Recommend referral to a specialist FoetalMedicine Assessment Unit. Repeat specimensrecommended every 4 weeks to week 28gestation, then every 2 weeks to delivery.Note: Subsequent referral for Anti-Dquantitation is of limited clinical valueCommentsReferral of maternalspecimen to IBGRLfor foetal Dgenotype.From 16 weeksReferral of maternalspecimen to IBGRLfor foetal Dgenotype.Anti-clevel IU/mlRisk ofHDNRecommendationComment 20 Risk ofSevereHDNRepeat specimens recommended every 4weeks to week 28 gestation, then every 2weeks to delivery.Recommend referral to a Specialist FoetalMedicine Assessment Unit. Repeat specimensrecommended every 4 weeks to week 28gestation, then every 2 weeks to delivery.Recommend referral to a specialist FoetalMedicine Assessment Unit. Repeat specimensrecommended every 4 weeks to week 28gestation, then every 2 weeks to delivery.Referral of maternalspecimen to IBGRLfor foetal Rh cgenotype.Referral of maternalspecimen to IBGRLfor foetal Rh cgenotype
IBTS/DIAG/GDE/0001 Ver. 2 Page 36 of 4112.1.2. Ante-Natal Specimens for Antibody TitrationAntibody Titre Recommendation CommentAnti-K N/A Anti-K can cause HDN irrespectiveof titre. Recommend referral to aFoetal Medicine Assessment Unit.Repeat specimens recommendedevery 4 weeks to week 28gestation, then every 2 weeks todelivery. Check Partner’s Kk type.If Kell negative and paternity canbe confirmed, repeat specimenrecommended at 28 weeksgestation. If partner’s Kell type isK positive or cannot be determined,then refer the maternal specimenfor foetal K genotype and adviserepeat specimens for antibodytitration every 4 weeks to week 28gestation, then every 2 weeks todelivery is recommended.OtherClinicallySignificantAntibodies≤32≥32Antibody titres ≤32 are associatedwith a low risk of HDN. Checkantibody levels at 28-32 weeksgestation. Referral of paternalspecimen for antigen typing and /or maternal specimen for foetalgenotyping (if appropriate)Antibody titres ≥32 are consideredclinically significant for HDN.Referral to a Foetal MedicineAssessment Unit is advised.Referral of paternal specimen forantigen typing and /or maternalspecimen for foetal genotyping( if appropriate)Check cord DAT atdelivery and monitor infantfor evidence ofhaemolysis.Check cord DAT atdelivery and monitor infantfor evidence of haemolysisCheck cord DAT atdelivery and monitor infantfor signs of haemolysis
Page 1 and 2: IBTS/DIAG/GDE/0001 Ver. 2 Page 2 of
Page 9 and 10: IBTS/DIAG/GDE/0001 Ver. 2 Page 10 o
Page 33: IBTS/DIAG/GDE/0001 Ver. 2 Page 34 o

IBTS DIAG GDE 0001 - Irish Blood Transfusion Service

You also want an ePaper? Increase the reach of your titles

Delete template?

Save as template?