Cord Blood Protocol

I. Principle:

Cord blood collected at the time of delivery is tested for ABO Group, Rh Type and Direct Antiglobulin Test.

II. Clinical Significance: N.A.

III. Specimen:

Cord blood collected in 0.5 ml Sodium Heparin (1000 usp/ml) at time of delivery. Interference with blood grouping tests may occur with contamination by Wharton’s Jelly and red cells heavily coated with any antibody.
Note: The technologist performing tests on a patient sample must confirm that all identifying information on the request form agrees with the information on the specimen label before using the specimen for blood grouping, typing or compatibility testing. Record verification by placing a check mark by “Specimen Integrity” on the test requisition.

IV. Materials:

Refer to the “ABO Group and Rh Type, Patient; MTS Monoclonal Grouping Cards” and "Direct Antiglobulin Test; MTS Gel" procedures.

V. Reagents:

Refer to the “ABO Group and Rh Type, Patient; MTS Monoclonal Grouping Cards” and "Direct Antiglobulin Test; MTS Gel" procedures.

VI. Standardization: N.A.

VII. Procedure:

1. Perform an ABO group and Rh(D) type on the cord blood specimen. (Refer to the “ABO Group and Rh Type, Patient; MTS Monoclonal Grouping Cards” procedure.)

A. Cord Blood workups should be completed as soon as possible.

B. Any reaction in the D well is interpreted as Rh Pos. Refer to the “ABO Group and Rh Type, Patient; MTS Monoclonal Grouping Cards” procedure.

C. A newborn with a positive monoclonal control test cannot be assigned a valid Rh type. The results, in this case, for the Rh typing must be written as follows: "CANNOT DETERMINE VALID RH TYPE".
Note: The Rh type cannot be determined in this case, however the mother of the child might be a candidate for Rh immune globulin. The physician and pathologist will decide whether or not she will receive it. Consequently, it is important to advise the pathologist of the status of the Rh type of the infant when consulting him/her.

2. Perform a direct antiglobulin test (DAT), IgG only. (Refer to "Direct Antiglobulin Test; MTS Gel Card" procedure.)

VIII. Limitations: N.A.

IX. Results Derivation:

Refer to the “ABO Group and Rh Type, Patient; MTS Monoclonal Grouping Cards” and "Direct Antiglobulin Test; MTS Gel" procedures.

X. Expected Result(s) and/or Critical Values:

Refer to the “ABO Group and Rh Type, Patient; MTS Monoclonal Grouping Cards” and "Direct Antiglobulin Test; MTS Gel" procedures.

XI. Quality Control:

Refer to the “ABO Group and Rh Type, Patient; MTS Monoclonal Grouping Cards” and "Direct Antiglobulin Test; MTS Gel" procedures.

XII. References:

1. Committee on Technical Manual, "AABB Technical Manual", American Association of Blood Banks, Washington D.C., current edition.

2. Policies of Pathology Associates.

3. See section XI. References in each of the procedures referred to in this protocol.

i. August 1981 S. Bertram

ii. February 1991 J. Steffen

iii. November 1998 B. Lucas (Revised: IV, V, VI, VII, VIII, IX, X.)

iv. September 2003 M. Burger (Revised: change D^u to weak D; format)

v. April 2006 S. Hosch, M. Burger, S. Rodriguez (Revised: VII.1-2.)

vi. September 2009 M. Burger (Revised: for MTS Monoclonal Grouping Cards, removal of weak D)

Comprehensive Review:

Pathologist:

Technical Director:

Interim Review:
May 2010 L. Watters (no changes)
Aubust 2011 E. Bartels (no changes)

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