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Newborn Rh Typing for RhIG (Cord Blood Testing/Heelstick)

HDN Survey, Cord Blood Testing, Type and DAT, Newborn Typing

Test Codes

EPIC: LAB5282, SOFT: CORD

Department

Blood Bank

Specimen Collection Criteria

Collect: Cord Blood - One Pink-top EDTA tube, properly labeled (single birth only). (Minimum Volume: 5.0 mL)
Also acceptable: Infant Heel Stick - One Pink-top EDTA Microtainer®, properly labeled. (Minimum Volume: 0.5 mL) 

It is extremely important that blood samples are accurately labeled. Labels must include the following information:

Farmington Hills, Grosse Pointe, Royal Oak & Troy

*Note: Cord blood specimens cannot be used for transfusion purposes.

Heel Stick Labeling: 

1. Patient's Name: Complete name, last name first. If the patient uses a first initial followed by a middle name, both must appear in proper order on the label. 
2. Wrist Band Number: Include the prefix letter, 5 numbers (example: N12345).  NOTE: Newborns who have not yet been discharged will likely still be wearing the "N" wristband; so for example, the sample should be labeled in the format "N12345." Specimens lacking this complete information cannot be used for blood transfusion purposes and will be rejected. 
3. Hospital Identification Number: The seven digit medical record number must be included on the label. 
4. Date and Time Collected 
5. Identification of Collector: Employee ID number must be on the sample tube or documented in the computer system.  

Cord Blood Labeling:

1. Patient's Name: Complete name of mother (first and last) with the words "cord blood" written on the label.
2. Wrist Band Number of the Infant: Include the prefix letter, 5 numbers (example: N12345).
3. Hospital Identification Number: Mother's hospital ID number must be on all cord blood specimens.
4. Date and Time Collected
5. Identification of Collector:Employee ID number must be on the sample tube or documented in the computer system.

Royal Oak & Troy

Cord Blood Labeling: 

1. HIS Label with Mother’s Name: Complete name of mother (first and last) with the words "cord blood" written on the label at Royal Oak.
2. LIS Label with Infant’s complete name (first and last) and hospital identification number.
3. Wrist Band Number of the Infant: Include the prefix letter, 5 numbers (example: N12345).
4. Hospital Identification Number: Mother's hospital ID number must be on all cord blood specimens on HIS label.
5. Date and Time Collected  
6. Identification of Collector: Employee ID number must be on the sample tube.

Farmington Hills & Trenton

Cord Blood Labeling: 

1. HIS label with Infant’s complete name (first and last) and hospital identification number.
2. Infant Wristband Number: Include the prefix letter, 5 numbers (example: N12345).
3. Date and Time Collected.  
4. Identification of Collector: Employee ID number must be on the sample tube.
5. Farmington Hills Only: Sample must arrive in a specimen bag with mother’s identification information which includes name, MRN, B number, date/time and initials of collector.

Dearborn, Grosse Pointe & Wayne Cord Blood Labeling:

1. LIS Label with Infant’s complete name (first and last) and hospital identification number. 
2. Infant Wristband Number: Include the prefix letter, 5 numbers (example: N12345). 
3. Date and Time Collected.  
4. Identification of Collector: Employee ID number must be on the sample tube. 
5. Cord Blood identified on label by sticker, color, or hand written.   

 

Rejection Criteria

• Improperly labeled specimens.
• Specimens with inadequate volume.
• Specimens collected in SST tubes.
• Specimens contaminated with IV fluids.
• Samples grossly contaminated with Wharton's Jelly.
• Hemolyzed samples will be tested only in emergency situations.
• Cord blood specimens on multiple births are not acceptable based on the risk of wrong blood in tube errors due to multiple cord samples being collected at the same time. Heelstick specimens will be requested.

Storage

Specimen Stability for Testing:

Room Temperature (20-26°C or 68-78.8°F): 24 hours
Refrigerated (2-8°C or 36-46°F): 72 hours
Frozen (-20°C/-4°F or below): Unacceptable

Specimen Storage in Department Prior to Disposal:

Refrigerated (2-8°C or 36-46°F): Specimens are held for a minimum of 11 days.

*Once a sample arrives in Blood Bank, it cannot be shared with other laboratories.

Laboratory

Royal Oak Transfusion Medicine Laboratory (Blood Bank)
Dearborn Transfusion Medicine Laboratory (Blood Bank)

Performed

Sunday – Saturday, 24 hours a day.
Results available within 8 hours (without unexpected test results).

Test Methodology

Hemagglutination.

Interpretation

• The Infant Rh typing for RhIG includes the Rh type (specifically, D antigen typing) on the infant cord blood or heel stick. Weak D testing will be performed on all samples that test Rh negative.
• Cord blood samples will only be tested if the mother is Rh negative, if hemolytic disease of the newborn is suspected, or if specifically requested by the physician.
• Mothers who are Rh negative whose newborn infants are Rh positive are candidates for Rh Immune Globulin prophylaxis.
• False positive results can occur if the specimen is contaminated with Wharton's Jelly.
• False negative or weakly positive results may occur if the D antigen sites on the cord red blood cells are heavily coated with maternal anti-D.

Clinical Utility

Newborn Rh typing for RhIG is used to determine if a mother who is Rh negative is a candidate for Rh Immune globulin prophylaxis.

CPT Codes

86901 (Rh)

Contacts

Last Updated

10/7/2023