Prenatal Testing and Prevention of Alloimmunization in Mothers of Saskatchewan (PRAMS) Program

 

In expectant mothers, it is standard of care for maternal blood group with Rh determination and antibody screen testing (ABO/Rh type and Ab Screen) to be performed to evaluate for fetal risk of hemolytic disease of the fetus and newborn (HDFN). Current clinical practice guidelines recommend that all expectant patients be typed and undergo a screen for alloantibodies at their first prenatal visit, with results of initial testing guiding the need for further investigations.

Prenatal transfusion medicine testing (ABO/Rh Type and Ab Screen) is currently provided to residents of Saskatchewan through Canadian Blood Services (CBS) in Vancouver.  This testing will transition to the Laboratories of the Saskatchewan Health Authority on February 3, 2020.  This allows us to provide care closer to home for our patients, improving the turn-around time and the information flow of test results electronically. These changes will impact your practice and improve the delivery of care for your patients.

Transmissible disease ordering and testing processes will remain unchanged.

Prenatal Transfusion Medicine Testing changes effective February 3, 2020

Facts you need to know:

  1. Test results will be available in e-Health and EMRs, as opposed to the current experience of receiving paper faxes from CBS.
  2. A new requisition will be in use effective February 3, 2020 titled Saskatchewan Health Authority, Prenatal Request for Testing. The new requisition will be pushed out to Accuro users and will be available for download from MedAccess in late January. Paper-based offices may access the new requisition under the FORMS section below.
  3. Antibody titer reporting will change. SHA laboratories use automated testing for antibody titers, which is considerably more sensitive than manual testing methods used by CBS. This will impact titer interpretation and the identification of critical thresholds for patients. The new critical threshold for referral to specialist care will be 64, rather than 16.
Test Centers

Routine Testing
Serving the former Cypress, Five Hills, Regina Qu’Appelle, Sun Country and Sunrise Health Regions:
Transfusion Medicine Laboratory
Regina General Hospital
1440 – 14th Ave.
Regina, SK S4P 0W5
Phone: 306-766-4474
Fax: 306-766-4004

Serving the former Athabasca, Kelsey Trail, Mamawetan Churchill River and Prince Albert Parkland Health Regions:
Transfusion Medicine Laboratory
Victoria Hospital
1200 24th St. West
Prince Albert, SK S6V 4B2
Phone: 306-765-6146
Fax: 306-765-6163

Serving the former Heartland, Keewatin, Prairie North and Saskatoon Health Regions
Transfusion Medicine Laboratory:
St. Paul’s Hospital
1702 20th St. West
Saskatoon, SK S7M 0Z9
Phone: 306-655-5168
Fax: 306-655-5101

Provincial Reference Testing
Transfusion Medicine Laboratory
Royal University Hospital
Room G502, 103 Hospital Dr.
Saskatoon, SK S7N 0W8
Phone: 306-655-2179
Fax: 306-655-2222

 

Resources

Forms

*** For the Accuro template, please access the Accuro Forms Editor and search for “SHA Request for Prenatal Testing (SK)”

Document Name Date of Original Publication Date Revised
Packaging Change for WinRho November 28, 2023 November 28, 2023 Download
PRAMS Program Rhlg Administration Report Form September 7, 2022 June 7, 2023 Download
PRAMS Utilization of Rh Immune Globulin (RhIg) Non-SoftBank Report Form February 5, 2020 November 20, 2020 Download
Request for Fetal-Maternal-Hemorrhage/Cord Blood Testing June 10, 2021 July 31, 2023 Download
Request for Prenatal Testing January 8, 2020 January 10, 2020 Download
Rhlg Monograph Information March 9, 2023 March 9, 2023 Download
SHA Request for Prenatal Testing Med Access Template January 28, 2020 January 28, 2020 Download
    Correspondence
    Document Name Date of Original Publication Date Revised
    CBS Customer Letter 2020-04 - Transfer of Routine Saskatchewan Prenatal ABO-Rh and Antibody Testing from Canadian Blood Services Vancouver to Saskatchewan Hospitals February 12, 2020 June 29, 2020 Download
    Memo Red Blood Cell Antigen Cell-free Fetal DNA (cffDNA) Testing Indications and Request Process April 5, 2023 April 5, 2023 Download
    Memo Rh Immunoglobulin (Rhlg; WinRho®) Information Resources and Confirmation of Administration Forms for Healthcare Providers April 5, 2023 April 5, 2023 Download
    Prenatal Testing Memo to All Healthcare Practitioners Ordering Prenatal Blood Testing February 12, 2020 February 13, 2020 Download
    Prenatal Testing Memo to All Healthcare Practitioners Ordering Prenatal Blood Testing in Lloydminster Hospital and Onion Lake, Saskatchewan February 12, 2020 February 13, 2020 Download

       

      FAQ's
      Document Name Date of Original Publication Date Revised
      Cord Blood Testing FAQ's July 15, 2021 July 15, 2021 Download
      Fetomaternal Hemorrhage FAQ's July 15, 2021 July 15, 2021 Download
      WinRho® FAQ's May 10, 2020 March 14, 2023 Download

         

        Patient Teaching Information
        Document Name Date of Original Publication Date Revised
        Antibodies Against Red Blood Cells in Pregnancy October 11, 2022 May 5, 2023 Download
        Hemolytic Disease of the Newborn (HDN) October 13, 2022 October 13, 2022 Download
        Rh (D) factor, Red Blood Cell Antibodies and Rh Immune Globulin: Following a Pregnancy Loss October 13, 2022 May 5, 2023 Download
        Rh (D) factor, Red Blood Cell Antibodies and Rh Immune globulin: Information for Rh Negative Women October 13, 2022 May 5, 2023 Download
        Ukrainian Translation - Rh (D) factor, Red Blood Cell Antibodies and Rh Immune Globulin: following a Pregnancy loss October 13, 2022 October 13, 2022 Download
        Ukrainian Translation Antibodies against Red Blood Cells in Pregnancy October 13, 2022 November 23, 2022 Download

           

          Algorithms
          Document Name Date of Original Publication Date Revised
          Algorithm 1 - Prenatal Transfusion Testing Overview July 27, 2020 July 27, 2020 Download
          Algorithm 2a - Prenatal Transfusion Testing for Women with a Positive Antibody Screen September 2, 2020 March 31, 2021 Download
          Algorithm 2b - Prenatal Transfusion Testing for Women with a History of Alloimmunization in Previous Pregnancies September 2, 2020 March 31, 2021 Download
          Algorithm 3a - Prenatal Testing for Rh Negative Women September 2, 2020 September 2, 2020 Download
          Algorithm 3b - Determination of Passive versus Immune D Status for Prenatal Rh Negative Women September 2, 2020 September 2, 2020 Download
          Algorithm 5 - Recommendations for Postnatal Follow-up of Infants and Newborns with HDFN September 4, 2020 September 4, 2020 Download
          Algorithms 4a-4c Management of Prenatal Transfusion Testing for Regina and Prince Albert July 28, 2020 September 3, 2020 Download

             

            Perinatal Best Practice
            Document Name Date of Original Publication Date Revised
            Perinatal Transfusion Medicine June 10, 2021 June 10, 2021 Download
            Peripartum Pre-Transfusion Testing May 3, 2023 May 3, 2023 Download

               

              Posters
              Document Name Date of Original Publication Date Revised
              Cord Blood Specimen Labelling and Testing Process Flow for Saskatchewan January 31, 2023 January 31, 2023 Download

                 

                Presentations
                Document Name Date of Original Publication Date Revised
                Prevention and Management of Alloimmunization in Pregnancy November 10, 2022 November 10, 2022 Download

                   

                  Contact Information

                  For questions, please contact:
                  PRAMS Provincial Program PRAMS@saskhealthauthority.ca or e-fax 306-974-3777.

                   

                  ProgramsPrenatal Testing and Prevention of Alloimmunization in Mothers of Saskatchewan (PRAMS) Program