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COOMBS' TEST

The Coombs' test measures antibodies on the surface of blood cells. Antibodies may occasionally form when a mothers blood type is different from her foetuss, or when more subtle differences between the mother's blood and the foetuss blood exist.

When a mother forms antibodies to the foetuss blood - usually because the two blood types have come into contact during either the pregnancy or the delivery the maternal antibodies attach to the baby's red blood cells, causing the baby's cells to die or break down. This, in turn, can cause short-term anemia or jaundice in the baby.

The Coombs' test is generally performed soon after birth using blood saved from the umbilical cord. Because the test uses blood collected during delivery, it does not require a heel prick or a vein stick to collect the specimen. If a Coombs' test is done beyond the newborn period, then a blood draw from a vein is required.

A normal result is called a negative Coombs. This means that the mother either did not make any antibodies against the baby's blood cells or did not make enough antibodies to cause any significant reaction. An abnormal result is called a positive Coombs, where the mother made a significant number of antibodies. The result can be microscopic, meaning that there was a very mild reaction

during the test; this indicates that the mother made at least some antibodies to the babys blood.

Many hospitals perform the test automatically if the mother has a blood type that can cause the antibody formation. The babies of mothers with type O-positive, Onegative, A-negative, B-negative, or AB-negative will likely be tested. It is possible, however, to have a positive Coombs' test with any maternal blood type.

ELECTROLYTES

Electrolytes are the "salts" in the bloodstream and the minerals found in tissues. They are responsible for the general balance in the body, helping to eliminate waste products while balancing the body's acidity and water levels. The electrolytes measured in this test include sodium (Na), potassium (K), chloride (CI), and bicarbonate (CO2). Water balance is most influenced by sodium. Acidity is affected by bicarbonate.

The electrolytes must be drawn from an artery or vein; the test cannot be done using a heel prick. The puncture site is cleaned with alcohol or another antiseptic, and a tourniquet is placed just above the area where the blood is to be drawn. This pressure restricts blood flow through the vein, causing the vein to fill with blood. Once the needle is inserted into the vein, blood is collected in a syringe or vial. Then the tourniquet and needle are removed, and the puncture site is covered with a piece of gauze or a bandage.

The blood must be sent to the laboratory shortly after it is drawn or the results may be unreliable. Occasionally the blood is drawn through such a small needle that cells break apart, leading to inaccurate values. This is especially true for potassium. In this case, the blood must be redrawn.

Electrolyte levels are often checked when a person has major organ (such as heart or kidney) involvement or when the fluid balance in the body is in question. Dehydrated babies will often have electrolyte levels checked. The electrolytes are replaced through our diet and can also be regulated by various hormones in

the body. If the levels are too low, then electrolytes can be replaced using oral or IV solutions in the hospital.

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