| Fetal Maternal Hemorrhage Screen (10005292) | |
|---|---|
| Test Mnemonic: | FMH |
| Specimen Requirements: | Post-partum maternal blood collected within 72 hours of giving birth |
| Test Included: | Rosette test to detect an excessive hemorrhage of Rh positive fetal cells in an Rh negative mother by using an anti-D reagent antisera and Rh positive indicator cells |
| Collection: | Routine venipuncture |
| Container: | Lavender-topped tube (EDTA) |
| Minimum Volume: | 3 mL blood |
| Storage/Transport: | Ambient temperature |
| Causes for Rejection: | Antepartum sample collected, neonatal sample submitted instead of maternal sample, specimen improperly labeled, requisition incomplete, serum separator tube used, gross hemolysis, frozen sample, failure to identify phlebotomist and verifier |
| Reference Range: | Postpartum: Negative; 1 vial Rh Immunoglobulin recommended. (If the baby is Rh negative, then Rh Immunoglobulin is not needed.) If positive, reflex quantitative FHS testing will be performed to estimate the extent of fetal-maternal hemorrhage and dosage of Rh Immunoglobulin required. |
| Turnaround Time: | 2 hours if negative; all positive tests will require FHS testing and an additional 2-4 hours of testing time |
| Methodology: | Red Blood Cell Rosettes |
| Performed: | Samples are accepted 24 hours per day at the Blood Bank lab, 4.404 Clinical Services Wing (CSW). |
| Synonyms: | Fetal Hemorrhage Screen, Fetal Screen, FMH, Rosette Test |
| Clinical Indication: | Rh negative mothers within 72 hours of giving birth to a Rh-positive infant; this test is not suitable for other patients or blood types. |
| Patient Preparation : | Collect sample after delivery |
| CPT 4 Code: | 85461 |
| Note: |
Specimens collected after Rh Immunoglobulin administration may yield inaccurate results. All requests must include the requesting physician's name and ID number, patient's complete name, UH number, current account number, patient location, clinical information/diagnosis, identity of phlebotomist and verifier, and date/time of sample collection. The specimen must be labeled with the patient's full name and UH number. Specimens should be transported to the laboratory in a biohazard specimen bag with the request form in the pocket of the bag. All information must be complete and legible on the specimen and the requisition. |
| When ordering tests for which Medicare or Medicaid reimbursement will be sought, physicians should only order tests that are medically necessary for the diagnosis or treatment of the patient. Components of the organ or disease panels may be ordered individually. The diagnostic information must substantiate all tests ordered and must be in the form of an ICD-10 code or its verbal equivalent. | |