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Blood test for antibodies
Rh antibodies belong to the so-called alloimmune antibodies. Anti-erythrocyte alloimmune antibodies(to the Rh factor or other erythrocyte antigens) appear in the blood under special conditions - after a transfusion of immunologically incompatible donor blood or during pregnancy, when fetal red blood cells carrying paternal antigens that are immunologically foreign to the mother penetrate through the placenta into the woman’s blood. Non-immune Rh-negative people do not have antibodies to the Rh factor. In the Rh system, there are 5 main antigens, the main (most immunogenic) is antigen D (Rh), which is usually referred to as the Rh factor. In addition to the Rh system antigens, there are a number of clinically important erythrocyte antigens to which sensitization can occur, causing complications during blood transfusion. The method of screening blood for the presence of anti-erythrocyte alloimmune antibodies, used in the Litech laboratory, allows, in addition to antibodies to the Rh factor RH1(D), to detect in the test serum alloimmune antibodies and to other erythrocyte antigens.
The gene encoding the Rh factor D (Rh) is dominant, the allelic gene d is recessive (Rh-positive people can have the DD or Dd genotype, Rh-negative people can only have the dd genotype). During pregnancy of a Rh-negative woman with a Rh-positive fetus, the development of an immunological conflict between mother and fetus due to the Rh factor is possible. Rh conflict can lead to miscarriage or the development of hemolytic disease of the fetus and newborns. Therefore, tests to determine blood group, Rh factor, as well as blood test for antibodies during pregnancy should be carried out when planning or during pregnancy to identify the likelihood of an immunological conflict between mother and child. The occurrence of Rh conflict and the development of hemolytic disease of newborns is possible if the pregnant woman is Rh negative and the fetus is Rh positive. If the mother has a positive Rh antigen and the fetus is negative, a conflict regarding the Rh factor does not develop. The incidence of Rh incompatibility is 1 case per 200-250 births.
Hemolytic disease of the fetus and newborns is hemolytic jaundice of newborns, caused by an immunological conflict between mother and fetus due to incompatibility of erythrocyte antigens. The disease is caused by incompatibility of the fetus and mother for D-Rhesus or ABO (group) antigens, less often there is incompatibility for other Rhesus (C, E, c, d, e) or M-, M-, Kell-, Duffy- , Kidd antigens. Any of these antigens (usually D-Rh antigen), penetrating into the blood of a Rh-negative mother, causes the formation of specific antibodies in her body. The penetration of antigens into the maternal bloodstream is facilitated by infectious factors that increase the permeability of the placenta, minor injuries, hemorrhages and other damage to the placenta. The latter enter the fetal blood through the placenta, where they destroy the corresponding antigen-containing red blood cells. 
Predisposition to the development of hemolytic disease of newborns is impaired placental permeability, repeated pregnancies and blood transfusions to a woman without taking into account the Rh factor, etc. With early manifestations of the disease, an immunological conflict may be the cause premature birth or miscarriages.
During the first pregnancy with an Rh-positive fetus, a pregnant woman with Rh "-" has a 10-15% risk of developing an Rh conflict. The first meeting of the mother's body with a foreign antigen occurs, the accumulation of antibodies occurs gradually, starting from approximately 7-8 weeks of pregnancy. The risk of incompatibility increases with each subsequent pregnancy with a Rh-positive fetus, regardless of how it ended (induced abortion, miscarriage or childbirth, surgery for an ectopic pregnancy), with bleeding during the first pregnancy, with manual separation of the placenta, and also if childbirth is carried out by caesarean section or accompanied by significant blood loss. with transfusions of Rh-positive blood (if they were carried out even in childhood). If a subsequent pregnancy develops with an Rh-negative fetus, incompatibility does not develop.
All pregnant women with Rh "-" are placed on special registration in antenatal clinic and carry out dynamic monitoring of the level of Rh antibodies. For the first time blood test for antibodies during pregnancy, it is necessary to take the test from the 8th to the 20th week of pregnancy, and then periodically check the antibody titer: once a month until the 30th week of pregnancy, twice a month until the 36th week and once a week until the 36th weeks. Termination of pregnancy at less than 6-7 weeks may not lead to the formation of Rh antibodies in the mother. In this case, during a subsequent pregnancy, if the fetus has a positive Rh factor, the probability of developing immunological incompatibility will again be 10-15%.
Testing for alloimmune anti-erythrocyte antibodies is also important in general preoperative preparation, especially for people who have previously received blood transfusions.
Indications for the purpose of analysis:
1. Pregnancy (prevention of Rh conflict);
2. Monitoring of pregnant women with negative Rh factor;
3. Miscarriage;
4. Hemolytic disease of newborns;
5. Preparation for blood transfusion.
Analyzes in the LITECH laboratory:
Research method: agglutination method
Material for research: 1 ml of venous blood in a test tube with EDTA (test tube with a lilac cap)
Preparation for the study: no special features
The presence of various antigen systems on erythrocytes is of great practical importance during blood transfusion. This is due to the fact that antibodies to them may be present in the recipient’s blood plasma. A reaction to incompatible blood transfusion occurs when the recipient's antibodies bind to the corresponding antigens on the donor's red blood cells.
This binding of antigens to antibodies leads to the destruction of the donor's red blood cells and is called hemolysis. Much less often, hemolysis occurs as a result of the destruction of the recipient's red blood cells by the donor's antibodies. This process can be observed during transfusions of donor plasma containing antibodies to the antigens of the recipient's erythrocytes. To describe such a complication of blood or plasma transfusion, the terms hemolytic transfusion reaction or post-transfusion hemolytic complication are used.
If the recipient's plasma does not contain antibodies to the donor's red blood cell antigens, their blood is said to be compatible and the donor's blood can be safely transfused.
To understand the basis of the development of a hemolytic transfusion reaction, the most important is the mechanism of the formation of antibodies to red blood cell antigens in the recipient’s body. Where do these epithelial bodies appear and under what situations?
It is well known from the basics of immunology that antibodies are formed only after the contact of lymphocytes with the corresponding foreign substance. For clinical practice, it is important to understand that there are two cases when recipient lymphocytes can interact with foreign erythrocyte antigens. The first of them is the transfer of donor blood and the second is pregnancy. “In the first cloud, the antigen directly enters the body with the donor’s red blood cells, and the recipient’s immune system responds to them with non-pythic antibodies. During pregnancy, fetal red blood cells can penetrate into the mother’s bloodstream If they contain on their surface antigens inherited from the father, and the mother’s red blood cells do not have these antigens, then the mother’s immune system regards the dark cells as foreign and begins to synthesize antibodies to them.
Let us recall that upon initial contact with a foreign antigen, the immune system produces a small amount of antibodies. They do not have any effect during the first blood transfusion or pregnancy.
pronounced damaging effect. However, as a result of primary contact with a foreign antigen, memory B lymphocytes are formed that store information about the antigen. Upon repeated contact with foreign erythrocyte antigens, they synthesize a large number of antibodies that can destroy the donor’s erythrocytes. Such antibodies are called anti-erythrocyte antibodies.
This mechanism of antibody production is of greatest practical importance in relation to antibodies to red blood cells carrying the RhD antigen (Rh factor system antigen). Of course, only those people who do not have the RhD antigen (15% of the population are Rh negative) can be immunized and produce anti D antigen. Approximately 1% of the population has such antibodies as a result of a previous blood transfusion or pregnancy. If such individuals are transfused with Rh-positive blood, the antibodies present in their plasma bind to antigens on the surface of their erythrocytes, causing their hemolysis.
However, the problem with hemolytic transfusion reactions is that immune anti-erythrocyte antibodies are not the only ones present in the recipient’s plasma. Therefore, not only people with a history of blood transfusion and pregnancy are at risk of receiving incompatible blood.
Let us recall that the clinical significance of the blood groups of the ABO system is that antibodies to erythrocyte antigens are present in the blood plasma initially (they are congenital), and do not appear as a result of previous immunization with foreign erythropites. Lipa with blood group 0 (there are no antigens A and B on red blood cells) have antibodies to both antigens (anti-D and anti-B) in their blood serum. People with blood type A (A antigen on red blood cells) have antibodies to the B antigen (anti-B). Persons with blood type B named AGP and A-antibodies. Approximately 3-4% of the population have the blood group AU (A and B antigens are present on red blood cells) and, therefore, contain antibodies in the blood serum.
The widespread prevalence and potential danger of the presence of anti-A and anti-B antibodies are of paramount clinical importance when determining the blood group according to the A BO system in the donor and recipient.
All other antibodies of clinical relevance appear, like anti-O antibodies, as a result of immunization and are absent in the serum unless the patient has a history of blood transfusion or pregnancy.
Thus, only the antibodies that initially exist in the human body - anti-A and lng-B - are of the most important clinical significance. Therefore, if the compatibility of the donor and the donor is ensured according to the ABO system, blood transfusion is 97% immunologically safe.
Test for alloimmune anti-erythrocyte antibodies- a laboratory test aimed at identifying antibodies to the Rh factor in Rh-negative blood - a specific protein that is located on the surface of the red blood cells of Rh-positive blood. The indicator has an independent diagnostic value; the study is carried out after receiving the results of tests to determine the blood group and Rh factor. The data is used to identify Rh conflict between mother and fetus and determine the need to administer immunoglobulin injections to a pregnant woman with Rh-negative blood. The material for the study is venous blood. The titer of anti-Rhesus antibodies is detected using an agglutination reaction. Normally, with a low probability of Rh conflict, the result is negative. The readiness of analysis results is 1 business day.
Anti-erythrocyte antibodies are immunoglobulins that are produced against various groups of erythrocyte antigens. These antigens belong to the structural formations of blood cells, located on the outer surface of the membranes. They are diverse in their chemical nature - some are represented by proteins, others by glycoproteins, and others by glycolipids. Their presence or absence is inherited and does not change throughout life. The set of antigens does not affect the health status in any way. If in the blood of a person who lacks red blood cell antigens certain type, transfuse blood with such antigens, the body will produce antibodies - an immune response will develop. Such situations arise after blood transfusions performed without preliminary analysis for antibodies to the Rh factor, as well as when fetal blood antigens enter the bloodstream of the pregnant woman.
Timely detection of anti-erythrocyte antibodies in the blood is necessary to prevent the development of Rh conflict, the consequences of which are hemolytic reactions, that is, the destruction of the donor's red blood cells. During pregnancy, spontaneous termination is possible at various stages. The study of antibodies to the Rh factor has become most widespread in obstetric and gynecological practice as a tool for monitoring pregnancies in women with Rh-negative blood. Timely vaccination with anti-D gamma globulin allows you to avoid the development of Rh conflict and associated complications. In addition, the study of antibodies to the Rh factor is in demand in surgical and intensive care practice as part of preparing patients for blood transfusions. To test for anti-erythrocyte antibodies, blood is drawn from a vein. A common research method is the agglutination reaction on a buffer gel.
Indications
A screening test for anti-erythrocyte antibodies in the blood is used to prevent extravascular hemolysis after blood transfusions and to prevent the development of fetal erythroblastosis in the fetus. Based on the test results, allosensitized patients are identified and prescribed necessary treatment. As part of preparation for pregnancy and its monitoring, a test for antibodies to the Rh factor is performed at certain intervals. The study is indicated for mothers with Rh-negative blood, provided that there is a possibility of transmission of a positive Rh factor from father to child. Particularly careful monitoring of anti-erythrocyte antibodies is required for women who have already been immunized previously - have had pregnancies with Rh conflict, including those that ended in abortion or miscarriage, or have undergone blood transfusions. Also, the risk of developing Rh conflict is higher in patients with pregnancy complications leading to disruption of the integrity or increased permeability of the placenta. The likelihood of penetration of fetal red blood cells increases with placental abruption, abdominal trauma, infections, and invasive interventions on the uterus. Based on the results of the analysis, a conclusion is made about the risk of developing Rh conflict and the need for immunoglobulin injections.
Other indications for testing for antibodies to the Rh factor include recurrent miscarriage and hemolytic disease of the newborn. The results of the study make it possible to confirm or refute the role of Rh conflict in the development of pathology. In surgery, resuscitation and related fields, testing for antibodies to the Rh factor is indicated in preparation for blood transfusions, as well as 15-30 days after the procedures. According to the study, sensitization to antigens and the possibility of blood transfusion from a specific donor are determined.
An anti-erythrocyte antibody test is not indicated if a woman with Rh-negative blood is carrying a child whose father also has Rh-negative blood. In these cases, the fetus's Rh factor is always negative, and an immunological conflict does not develop. The results of the study may be positive in the absence of Rh conflict if the injection of anti-Rhesus immunoglobulin was administered to the woman less than 6 months ago. Another limitation of the analysis is its sensitivity - in small concentrations, anti-Rhesus antibodies cannot be detected. Despite this, the predictive value of the study is very high - its results make it possible to identify the risk of Rh conflict and prevent its development.
Preparation for analysis and collection of material
When performing an analysis for anti-erythrocyte antibodies, the biomaterial is venous blood. The collection procedure is usually carried out in the morning, but there are no strict requirements for the time it is carried out. There is no need to prepare to donate blood. It is recommended to take a break after eating for at least 4 hours, and spend the last 30 minutes before the procedure in a calm environment, without emotional and physical activity. Blood is taken from the ulnar vein by puncture, placed in a sealed tube and sent to the laboratory within a few hours.
Antibodies to the Rh factor are determined in the blood by agglutination using gel filtration. During the procedure, serum with red blood cells is injected into top part microtubes with gel. They are then incubated and centrifuged. As a result, agglutinated red blood cells (those associated with anti-erythrocyte antibodies), due to their increased size, do not pass through the gel and remain on its surface. If there are no antibodies, then the red blood cells easily sink through the gel to the bottom of the tube. Thus, the presence of antibodies to the Rh factor is determined by the nature of the distribution of red blood cells. The turnaround time for the analysis is 1 business day.
Normal values
Normally, the result of the test for anti-erythrocyte antibodies is negative (-). This means that there are no antibodies in the blood sample being tested, and the likelihood of developing a Rh conflict is low. The final indicator is not influenced by physiological factors, such as physical activity or dietary habits. Incorrect storage and transportation of the blood sample can lead to false results.
Increasing values
If there are anti-erythrocyte antibodies in the pregnant woman's blood, the test result is positive. In this case, a semi-quantitative study is carried out. Depending on the strength of the agglutination reaction in the gel, the result can be strongly positive (++++), positive (+++), weakly positive (++), very weakly positive (+). The reason for the increase in the analysis values for anti-erythrocyte antibodies is the body’s sensitization to the Rh factor. She testifies increased risk termination of pregnancy, the risk of developing erythroblastosis of the newborn and complications after blood transfusions.
Decrease in values
The absence of antibodies to the Rh factor in the blood is normal and indicates that there is no risk of developing a Rh conflict. If antibodies were determined earlier, then the reason for the decrease in analysis values is the introduction of anti-D gamma globulin.
Treatment of abnormalities
Analysis for anti-erythrocyte antibodies has diagnostic and prognostic significance in obstetric and gynecological practice. Its results make it possible to identify the risk of developing an immunological conflict in a pregnant woman with Rh-negative blood and promptly administer immunoglobulin. This measure allows you to avoid further complications: hemolytic disease of the fetus or newborn, miscarriage, premature birth. With the results of the analysis, you must contact the obstetrician-gynecologist leading the pregnancy.
IN3.1. In the case of a planned blood transfusion, recipients must undergo preliminary antibody screening (see paragraphs B2 and C 1.2). Test red blood cells for antibody screening in recipients should not be mixed (pooled).
IN3.2. Sample results should be verified against previous testing records, if available. Previous records are reviewed for pre-existing clinically significant antibodies, testing difficulties, and adverse transfusion reactions.
IN3.3. Identification of anti-erythrocyte antibodies
IN3.3.1. Irregular anti-erythrocyte antibodies can be detected in a patient at different stages of immunohematological research: cross-determination of ABO blood groups, compatibility tests, antibody screening. If anti-erythrocyte antibodies are detected in a patient, their specificity must be determined.
IN3.3.2. To establish the specificity of antibodies identified by primary screening, it is necessary to use a panel of red blood cells, including at least 10 samples. The panel of standard red blood cells should consist of a combination of phenotypes that allows the specificities of the main clinically significant antibodies to be determined:
monospecific and polyspecific anti-D, -C, -C w, -c, -E, -e, -K, -k, -Fy a, -Fy b, -Jk a, -Jk b, S, -s, (-M, -Le a, -PI).
IN3.3.3. When establishing specificity, extended typing of erythrocytes of the person in whose serum antibodies are detected is recommended.
IN3.3.4. If it is known that the patient already has antibodies, their specificity should be established each time a study is performed to exclude antibodies of a different specificity that could be developed additionally. To identify newly formed antibodies of additional specificity, it is necessary to use red blood cells for research that do not contain antigens against antibodies that have already been identified. The specificity of the antibodies is confirmed by 3 antigen-positive and 3 antigen-negative samples of donor red blood cells.
IN3.3.5. If antibodies to red blood cell antigens are detected, a response is written and recorded in the medical history. The answer must indicate that if blood transfusion therapy is necessary, individual blood selection is carried out using an antiglobulin test. The response form remains with the patient, is stored throughout life and is presented upon hospitalization."
IN3.3.6. If a recipient has once been identified with clinically significant antibodies to erythrocyte antigens, such a recipient should always, even if subsequently antibodies of the specified specificity cease to be detected in the serum, should receive a blood transfusion medium that does not contain antigens to antibodies of the identified specificity.
The selection of blood donors for patients with irregular antibodies is carried out in the laboratory. Donor red blood cells intended for transfusion should not have antigens identical to the recipient's antibodies. If typed donor blood samples are not available, donor blood samples that are compatible in the indirect antiglobulin test are used for selection. Blood samples that show a negative AHT result, although they react with the recipient's serum at room temperature, may be selected for transfusion (provided that laboratory testing does not reveal antibodies of clinical significance).
Q4. Pre-transfusion tests
Except in emergency situations, blood compatibility tests between the donor and recipient should be performed. Methods should detect ABO incompatibility and clinically significant antibodies (it is better to use the antiglobulin method or its analogues). All control studies are performed on a freshly taken blood sample from the patient.
B4.1. ABO blood group control.
Immediately before the transfusion, the doctor again determines the ABO affiliation of the blood of the donor and the patient and compares the results with the entry in the medical history and with the designation of the donor’s blood type on the container (bottle). The study is carried out with standard sera or zoliclones.
B4.2. Donor red blood cells, which are used to determine ABO affiliation or in compatibility tests, are obtained from a segment of tubing from a plastic bag or from a system during the initial filling of donor blood.
IN4.3. Cold compatibility test. Immediately before the transfusion, the doctor should perform a cold test for compatibility between the patient’s serum and the donor’s red blood cells, performed at a temperature of 15-25 ° C and clearly revealing ABO incompatibility (on a plane without heating, agglutination in a gel, spin method).
IN4.4. Thermal compatibility test
Immediately before the transfusion, the doctor must perform a thermal test for compatibility between the patient's serum and the donor's red blood cells using the conglutination method with gelatin, 33% polyglucin or an antiglobulin test (gel test).
IN4.5. Testing for compatibility in laboratories For sensitized recipients, testing for
compatibility should be performed in an immunohematology laboratory. In this case, sensitive tests are used that detect clinically significant antibodies in compatibility tests, including the antiglobulin test. If pre-transfusion tests are performed in the laboratory, a “compatibility form” is filled out, which is pasted into the medical history, and a thermal compatibility test is not required before transfusion.
IN4.6. Individual selection of donor blood
An individual selection of donor blood is carried out by a laboratory doctor at a healthcare facility, department of medical education or training center, who has special training in immunohematology.
The patient undergoes an individual selection of donor blood if the following indications exist:
Compounded transfusion or obstetric history (reaction)
tions and complications from previous blood transfusions, pregnancies that resulted in the birth of newborns with jaundice or other signs of tension-type headache);
Patients with anti-erythrocyte alloantibodies in the serum);
Difficulty determining blood type;
Positive or questionable result of individual compatibility tests;
Patients who are expected to undergo multiple transfusions;
Newborns with signs of hemolytic disease;
Individual selection of blood is carried out taking into account the specificity of the recipient's antibodies among phenotyped donors. If multiple transfusions and transfusions are necessary for children, individual selection of blood is carried out taking into account the specificity of antibodies and the phenotype of erythrocyte antigens of donors and recipients.
IN5. Emergency transfusions
During immunohematological examination of recipients in emergency cases, the medical staff on duty transfusion of blood transfusion media must:
Determine the blood group of the ABO system using standard ABO hemagglutinating sera or anti-A and anti-B, anti-AB coliclones;
Determine Rh status using the universal anti-D reagent or anti-D super coliclone;
Conduct compatibility tests.
Screening for irregular antibodies before emergency blood transfusion is not performed, but should be done retrospectively, after transfusion, on a pre-transfusion blood sample of the patient.
IN6. Post-transfusion hemolytic complications
IN6.1. If a patient detects signs of a post-transfusion complication, the doctor is obliged to:
Stop transfusion;
Re-check the blood group of the ABO system of the patient and the donor, compare the designations on the bottle (bag). In case of discrepancy, immediately carry out therapeutic actions;
Take 2 samples of the patient’s blood and visually evaluate the staining of the patient’s serum for hemolysis. One blood sample is sent to the clinical laboratory of the medical institution, another sample of the patient’s blood, together with the pre-transfusion sample and the remains of the blood transfusion medium in the bag (vial), is sent to the immunohematology laboratory of the SPK;
Take a sample of the patient's urine, evaluate it and send it to the clinical laboratory of the medical institution.
IN6.2. Perform the following tests in the clinical laboratory of a medical institution:
Free hemoglobin in serum (plasma);
Bilirubin;
Hematocrit;
Report the results of the study to the immunohematology laboratory of the SPK.
IN6.3. Perform the following studies in the immunohematology laboratory of the SEC:
Visually assess the color of the post-transfusion serum sample for hemolysis;
Conduct ABO, Rh, Kell control of the patient (pre- and post-transfusion samples) and donor;
Perform compatibility tests;
Perform alloantibody screening;
If alloantibodies are detected, identify them;
Perform direct AGT on the post-transfusion sample;
Conduct a study of alloantibodies in the eluate;
If necessary, make an individual selection of donor blood.
The study of blood type, Rhesus, alloantibodies of donors and recipients in difficult cases must be carried out in accordance with the methodological recommendations "Algorithms for the study of erythrocyte antigens and anti-erythrocyte antibodies in difficult-to-diagnose cases" No. 99/181. Approved by the Ministry of Health of the Russian Federation on May 17, 2000.
Rh antibodies belong to alloimmune antibodies; they appear in the body in the following cases:
1) When transfusing immunologically incompatible donor blood;
2) During pregnancy, at the moment when the fetal red blood cells, which carry paternal antigens that are immunologically foreign to the mother, will penetrate the placenta into the woman’s blood.
There are several main antigens in the Rh system. The main one is D, which is where incompatibility most often arises. Less often, but also occurs, incompatibility with other antigens of the Rh system (for example, C, E, c, d, e). Absolutely any of these antigens, when entering the bloodstream of an antigen-negative patient, will cause the formation of specific antibodies there.
The identification of anti-erythrocyte alloantibodies currently has very serious clinical significance in order to prevent the development of hemolysis of donor erythrocytes. It is also widely used to identify allosensitized individuals and in the prevention of hemolytic disease of newborns.
Hemolytic pathology of the fetus will develop in situations where a pregnant woman with Rh-negative blood has a fetus with Rh-positive blood, but provided that this woman was previously sensitized to the Rh factor. Of the possible antibodies to Rh system antigens, the most severe course of hemolytic disease of the newborn will be caused by antibodies to the D antigen.
Hemolytic disease of the fetus is a disease that occurs in women who give birth more than once. This is due to the fact that the process of immunization of the mother with red blood cells of the fetus and the immune response itself will usually not fit within one gestational age. This is possible if a primigravida has previously had abortions, blood transfusions without taking into account the Rh factor, or a cesarean section. Only in such cases is it possible for the fetal blood to enter the mother’s bloodstream - in other words, sensitization of the maternal body is possible.
It is imperative to conduct a test for the presence of anti-erythrocyte alloantibodies at the moments before each blood transfusion. If the recipient has undergone even one transfusion of blood components, then in the future he will already be in the “risk” group, since in most situations, the transfusion occurs without any typing of erythrocyte antigens, and the person can be sensitized by the erythrocyte antigen he does not have. Repeated transfusions of donor red blood cells are possible if there is an immune response, during which the synthesis of anti-erythrocyte alloantibodies occurs, and subsequently extravascular hemolysis occurs.
The following indications for the purpose of this analysis are distinguished:
1) In order to carry out preventive measures regarding Rh conflict in pregnant women;
2) Monitoring the level of Rh antibodies in pregnant women over time;
3) If necessary, monitoring for miscarriage;
4) Detection of hemolytic pathology in newborns;
5) Planned preparation of patients for blood transfusion.
- Blood for research is taken strictly on an empty stomach; at least 8 hours must pass between the last meal and blood collection. Juice, tea, coffee, especially with sugar, are also food, this must be remembered. Drinking water does not affect blood counts.
- 1-2 days before the examination, it is advisable to exclude fatty, fried and alcohol from the diet. Refrain from smoking a couple of hours before taking blood.
- One day before donating blood, it is advisable to avoid physical activity; you should also avoid physical stress (running, climbing stairs) and emotional excitement before donating blood. Before the procedure, you should rest for 10-15 minutes and calm down.
- Blood should not be donated immediately after an x-ray, ultrasound, massage, reflexology or physiotherapeutic procedures.
- If possible, avoid taking medications. Some types of studies (for example, dysbiosis) are done strictly before taking antibiotics and chemotherapy drugs. The exception is special studies of drug concentrations in the blood. If you have difficulty stopping your medications, be sure to tell your doctor.