In response to Chris Booth's message - this is interesting - where is your
unit located and is there a contact person for people who would like more
info?
Cheers
Michel
Michel Burgum
Combined Universities Centre for Rural Health
PO Box 109 Geraldton
Western Australia 6531
Tel. 61+ (08) 99560209
Fax. 61+ (08) 99642096
Mobile 0418937220
Join the nurses midwives rural regional and remote list on:
http://ruralnursemid.listbot.com/
-----Original Message-----
From: [log in to unmask]
[mailto:[log in to unmask]]On Behalf Of Christine
Booth
Sent: Friday, 24 November 2000 12:50
To: [log in to unmask]
Subject: Re: folic acid
----- Original Message -----
From: Gwenan Thomas <[log in to unmask]>
To: <[log in to unmask]>
Sent: Monday, November 20, 2000 4:44 PM
Subject: folic acid
Is anybody familiar with the practice of prescribing Folic acid to newborn
babies who are direct coombs positive. I am interested infinding out if
there are any units that do this, and if anybody has any relevany
information, refs etc
many thanks Gwenan
Dear Gwenan,
Yes, the Paeds at out unit DO prescribe folic acid to babies whose
Direct Coombs test is positive.
For the non-midwives on this list, the Coombs test detects maternal
antibodies on the baby's red blood cells. These antibodies cause a breakdown
of the red cells (haemolysis). If cells ARE destroyed, to make new red cells
the baby needs Iron (a term baby will have stores, a pre term is given iron
as Sytron medicine), vitamin B12 (baby should have stores), and folic acid.
In the unit where I trained, if the mum was RhDneg, after the birth we
took the Kleihaur from Mum to detect if any fetal blood has got into the
mum's circulation at the birth, which will cause antibody formation if the
baby's blood is RhesusD pos. Then we took cord (baby's) blood to check the
baby's blood group to see if it was the same as mum's. We did the Direct
Coombs AND a serum bilirubin to see if there HAD been any breakdown of red
cells at that time. Incompatibility could also occur between mum/baby of
different blood group (ABO incompatibility), never mind the Rhesus bit, but
that is a different story
It seems that any baby with a positive Coombs test goes on folic acid,
at our unit, even with no symptoms eg jaundice, and even without doing a
serum bilirubin test.
Hope this answer makes some sense, and is not too late. It seems ages
since I first saw your request for info, then your second notice saying you
had not had any replies. I was just plucking up courage to make a comment,
as physiology is not my strongest point. I did not know if you were a
midwife just wanting a Yes/No answer, or if you wanted some explanation.
Love Chris Booth
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