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Contributed by Darlene Mueller, ART, Matsqui - Abbotsford - Sumas (MSA) General Hospital
Mrs. D.M. is a 34 year old female admitted at 37 weeks gestation for induction of a twin pregnancy.
A group and screen was ordered but because of the antibody history three units of Jk(a-) concentrated red cells were crossmatched.
Given these crossmatch results, the technologist notified the attending physician that there were additional antibodies present and compatible blood was not available at this time. She also requested cord bloods as soon as possible.
Female (twin A) and male (twin B) babies were born without incident later the same day. Cord blood testing results were as follows:
As a follow-up a blood specimen was taken from the father:
After reviewing the case summary, consider these questions:
Bowman JM, Pollock JM, Manning FA, Harman CR, Menticoglou S. Maternal Kell blood group alloimmunization. Obstet Gynecol 1992;79(2):239-44. [ Medline ]
Canadian Paediatric Society. Approach to the management of hyperbilirubinemia in term newborn infants. Paed & Child Health 1999;4(2):161-4. (revision in progress March 2002)
Graphpad. Online tool for calculating p values
Judd WJ. Practice guidelines for prenatal and perinatal immunohematology, revisited. Transfusion 2001 Nov; 41(11): 1445-52.
Judd WJ, Davenport R. On the high probability that a perceived lack of value of obtaining a p value will be detrimental to patient care. Transfusion 1997; Aug;37(8):877.
Kanter MH, Poole G, Garratty G. More on p values in antibody identification. Transfusion 1997;37(11-12):1221-2.
Sterne JA, Davey Smith G. Sifting the evidence-what's wrong with significance tests? (Br Med J 2001;322:226-31.