Basingstoke and north hampshire hospital pathology user handbook

Immunoglobulin Anti-D
Immunoglobulin Anti-D is issued by the Transfusion laboratory to all Rh negative women who give birth to a Rh positive infant. The following possible sensitisation events should also receive anti D in Rh D Negative women in the prevention of HDN, 250 IU before 20 weeks and 500 IU after 20 weeks:
-still birth

-APH

-amniocentesis

-trauma in pregnancy

-abruptio placentae

-turning a breech

-TOP

-threatened abortion

-miscarriage/Inevitable abortion (unless <12 weeks and spontaneous)

-intrauterine death

-post foetal blood sampling

-pv bleed (unless <12 weeks)

Prophylactic Anti-D
The Trust offers prophylactic Anti-D to all Rh D Negative women during their pregnancy. They will receive 1500 IU Anti-D at 28 weeks gestation. Cord bloods are taken at delivery, and if a Rh D Positive child is born, a further dose of 500 IU Anti-D is given.

After booking bloods are tested, all Rh D Negative women will receive a blood group card, an information pack on Anti-D Prophylaxis, and an invitation to take part.

The midwife orders the Anti-D from the Transfusion Department on special forms and the Anti-D is sent out to the clinic the day before required. See Prophylactic Anti-D Guidelines.
Crossmatch blood

All blood held for operations will be reclaimed to stock the day after the operation. Any blood remaining 48 hours after the start of any blood transfusion will be reclaimed to stock. If further blood is required, a fresh specimen of blood is needed for a repeat crossmatch.

Group and Save serum
Specimens sent for Group and Save serum will be tested and are valid for 7 days providing the patient has not been transfused. If a crossmatch is subsequently required, the clinician only needs to phone the Transfusion laboratory to convert the Group and Save serum to a crossmatch.
Standards in Blood Transfusion Practice
All the Guidelines for Blood Transfusion and blood component therapy are contained in the document “Standards in Blood Transfusion Practice” which is available on each ward station and via the intranet.
Blood Bank Training
It is essential that all staff who remove blood from the Blood Bank have received training.

Blood Bank training can be arranged to train staff in the hazards of blood transfusion and the procedure for removing blood from the Blood Bank. This is also accompanied by the NBA film, “The Strange Case of Penny Allison” which points out the dangers in Blood Transfusion. All staff attending will receive a certificate of training, and a log on code for the computer system. Contact Mr Roger Chant for training information or book on the MLE website.

Antenatal Antibody Clinic
Pregnant ladies with antibodies should be referred to the Transfusion Specialist Practitioner Roger Chant who will discuss with them the nature and problems associated with the antibodies. Appointments can be made via ext 4756 or ext 3290