Page 184 - pathology_services_handbook_5th_edition_2018

4.3 Cord TSH for Congenital Hypothyroidism Screening Programme

1. Immediately after delivery, clean the maternal side of the cord with sterile gauze
HTAA, KUANTAN 2. Allow free flow of blood from the cord directly to the tube. If there is a need to
and collect the blood sample.
‘milk’ the cord, do it gently to prevent hemolysis.
3. The tube should be filled with a minimum of 3 ml of blood. Allow space for the
cap to be pushed in.
4. Label the tube immediately.
5. Complete the investigation form (HTAA-OBG-B-015)
6. Send the sample and request form to the laboratory at the normal routine
intervals.

Notes:
If for some reason the blood sample has not been taken from the cord, then it should
be taken from the baby as soon as possible after the third day of life. This is to avoid
the TSH surge that occurs from 1/2 hour after birth to about 72 hours of age and to
ensure early treatment before 2 weeks of life for better prognosis. Blood samples
collected after the 3rd day of life should be a venous samples of at least 2 mls.

4.4 Drug of Abuse Testing

1. Specimen collected must be properly supervised. Collection site must have
suitable toilet facilities and are free from soap, dispenser or cleaning agent.
2. Urine specimen should be collected in duplicate using 30 ml clean leak-proof
container and should be filled up at 2/3 full each. This is to ensure that further
analysis can be carried out to confirm the presence of drugs in the urine.
3. The urine containers should be securely capped and sealed.
4. Containers are labeled in front of suspect/ donor with the following particulars:
• Name
• I.C Number
• Date of Collection
• Time of Collection
• Signature of person:
a) Supervising the collection process
b) Suspect/ donor

5. The authorized personnel to request drug analysis should be a qualified Medical
Officer/ Sergeant and above.

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