- Seek informed consent for screening (HIV, Syphilis and hepatitis B)
- Fill one 9ml purple topped EDTA bottle and complete a virology request form, clearly indicating which tests (HIV, Syphilis and hepatitis B) are to be carried out. Even if a woman does not consent to all three tests, please fill one 9ml purple topped EDTA bottle. Do not send two 5ml bottles, or other combinations to make up to 9 ml, the machines in the lab won’t accept them and the sample will not be processed.
- Ensure tests are recorded on the maternity electronic record.
- Mark the sample as URGENT and email the West of Scotland Specialist Virology Centre to let them know it is in the system on west.ssvc2@nhs.scot. State that the patient is a late booker.
- Send the sample to the virus lab, via normal routine processes.
- Ensure that the name and contact details of the person and a deputy who will be responsible for any positive results are clearly appended
- Note that to view a result on portal a CHI number is essential
Infectious Diseases Screening Tests in Late Bookers (357)
Warning
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Late bookers are women who present for the first time on or after 22 weeks of pregnancy. This is the stage at which the baby is potentially viable if early labour occurred.
The results of the infectious disease screening tests could affect the management at or after delivery, therefore all infectious diseases screening test results for a woman should be known prior to delivery and certainly before discharge.
If a woman presents to maternity services as a late booker i.e. on or after 22 weeks it is important to ensure that screening has been offered and results are received.
- Seek informed consent for screening (HIV, Syphilis and hepatitis B)
- Fill one 9ml purple topped EDTA bottle and complete a virology request form, clearly indicating which tests (HIV, Syphilis and hepatitis B) are to be carried out. Even if a woman does not consent to all three tests, please fill one 9ml purple topped EDTA bottle. Do not send two 5ml bottles, or other combinations to make up to 9 ml, the machines in the lab won’t accept them and the sample will not be processed.
- Ensure tests are recorded on the maternity electronic record at next opportunity.
- Mark the sample as ‘URGENT’ and email the West of Scotland Specialist Virology Centre before you send the sample
- In hours(9.00 – 17.00 Monday to Friday), email the virology lab at west.sscv@nhs.scot
- Explain that an urgent sample is being sent;
- Discuss the travel arrangements and arrange when and to whom the results will be communicated.
- Out of hours (including Saturday and Sunday).
- Please telephone the on-call virologist via the Switchboard 0141 211 4000 and discuss the above.
- If the timing of the local transport systems does not facilitate urgent transfer order a taxi to ensure the sample reaches the laboratory. (see NHSGGC Amended Protocol Ordering and Use of Taxis and Couriers October 2011 [Staffnet link])
- In normal hours the lab is able to process and produce results within 1-2 hours of receipt. Note that reactive samples will need to be confirmed on the next day.
- Note that to view a result on Clinical Portal, a CHI number is essential.
It is the responsibility of the labour ward staff to ensure that virology screening tests are offered and results received. Even intrapartum diagnosis can significantly, positively modify neonatal outcome therefore it is important to ensure women are offered screening tests no matter how late.
It is essential that you telephone the virology lab as soon as possible to discuss emergency testing of the woman.
- Seek informed consent for screening (HIV, Syphilis and hepatitis B)
- Fill one 9ml purple topped EDTA bottle and complete a virology request form, clearly indicating which tests (HIV, Syphilis and hepatitis B) are to be carried out. Even if a woman does not consent to all three tests, please fill one 9ml purple topped EDTA bottle. Do not send two 5ml bottles, or other combinations to make up to 9 ml, the machines in the lab won’t accept them and the sample will not be processed.
- Ensure tests are recorded on the maternity electronic record at next opportunity.
- Mark the sample as ‘URGENT’ and telephone the West of Scotland Specialist Virology Centre before you send the sample.
- In hours (9.00 – 17.00 Monday to Friday), telephone the laboratory on 0141 201 8722 and:-
- Explain that an urgent sample is being sent;
- Discuss the travel arrangements and arrange when and to whom the results will be communicated.
- Out of hours (including Saturday and Sunday) Please telephone the on-call virologist via the Switchboard 0141 211 4000 and discuss the above.
- Order a taxi to ensure the sample reaches the laboratory. (see NHSGGC Amended Protocol Ordering and Use of Taxis and Couriers October 2011 [Staffnet link])
- As with ALL emergency blood tests ensure results are followed up immediately they are available. In normal hours the lab is able to process and produce results within 1-2 hours of receipt.
- Communication with paediatricians is essential as their management may be significantly altered by these results however the responsibility for taking and sending these investigations and obtaining these results remains with the midwifery / obstetric team.