Effective January 4, 2023, the process for reporting the Microalbumin/Creatinine ratio was changed for situations where one of the results, microalbumin and/or creatinine, is below or above the assay’s analytical measuring range (AMR).
Obstetrics & Gynecology
Corewell Health Laboratory (Grand Rapids) Coagulation laboratory is pleased to announce a change to our von Willebrand factor (VWF) activity test. The historical test von Willebrand ristocetin cofactor (LAB335) will be retired and replaced by von Willebrand factor activity (VWF activity, LAB1230904) on January 17, 2023.
Starting November 29th, 2022, Corewell Health West, Hematology Laboratories will begin reporting absolute counts for white blood cell (WBC) manual differentials, in addition to relative (percentage) counts. The WBC differential count determines the number of each type of white blood cell present in the blood. It can be expressed as a percentage or as an absolute value. Of these, the absolute value is much more important than the relative value, given that clinically relevant WBC elevations and declines are defined by their absolute numbers, not by their relative proportions, and there is potential for error if this conversion is performed outside the laboratory.
Effective November 21, 2022, the following changes will be made to Meconium Drug Testing (LAB479).
- The cutoff for positivity for the opiate drug class (codeine, morphine, hydrocodone, hydromorphone, oxycodone, and oxymorphone) will increase to 20 ng/g from 10 ng/g.
- The format of reporting will be updated to include discrete reporting fields for all tested analytes. Positive results will no longer be denoted via comments.
Update: Swabs for Cultures without a Source and Order
Effective May 9th, 2022, Spectrum Health Laboratory’s Microbiology Department will no longer be preemptively setting up cultures on swabs without a source and order, when received on Thursdays through Sundays and Holidays. Note: The specimen will still be held, but cultures will not be set up in anticipation of the order.
Discontinuation of Low-Volume and Individual Fluorescence in situ Hybridization (FISH) Probes
Effective immediately, due to low test utilization and the high cost of maintaining proficiency, the following FISH tests will no longer be offered:
• Prader-Willi/Angelman (15q11-q13) by FISH
Recommended test is Angelman/Prader-Willi mPCR
• Smith Magenis (17p11) by FISH
If need arises for this test, please place an order for a Send out Genetics Miscellaneous and enter requested test in the comments. The testing will be sent out through Spectrum Health.
Any questions about referral testing may be directed to the Referral Department. Any questions or concerns regarding these changes may be directed to Dr. Salah Ebrahim in the Cytogenetics Laboratory.
Discontinuation of Placenta Microbiology Cultures
As of April 12, 2022, Spectrum Health Laboratory will no longer add microbiology cultures to placental tissues received based on paper requisition forms.
Viral and bacterial cultures from placental tissue are rarely clinically beneficial and are no longer the gold standard diagnostic approach due to the relative insensitivity of culture methods.
If viral studies are desired (possible indications could include known CMV exposure with positive IgM or intrauterine fetal demise at < 28 weeks), then molecular testing is the recommended diagnostic approach. HSV and CMV PCR tests may be ordered in Epic.
• Herpes Simplex 1/2 Qualitative PCR, Tissue (LAB1230413)
• Cytomegalovirus (CMV) Qualitative PCR, Tissue (LAB1230291)
Bacterial cultures are challenging to interpret since they typically grow normal genital flora and histopathological analysis used to diagnose acute chorioamnionitis correlates poorly with growth from bacterial placenta cultures. If indicated, culture and PCR tests may be ordered in Epic.
• Metamycoplasma hominis, Molecular Detection, PCR, Varies (LAB848)
• Ureaplasma species, Molecular Detection, PCR, Varies (LAB848)
Placenta tissues sent to the lab in formalin are not acceptable for PCR or culture orders.
MTHFR C677T [LAB7390], the methylenetetrahydrofolate reductase mutation analysis, is being discontinued as an obsolete test.
The American College of Medical Genetics (ACMG) and American College of Obstetricians and Gynecologists (ACOG) have determined that MTHFR C677T testing has minimal clinical utility. Current testing recommendations indicate that this test should not be ordered as part of a routine evaluation for thrombophilia or adverse pregnancy outcomes.
On January 24th, 2022 Rubella Antibody, IgG, Serum (LAB496) and Rubella IgG Antibody Quantitative (LAB3544) will be combined as LAB496 and moved to the Immunochemistry laboratory due to reagent constrains with the current vendor.
Testing will be available Monday-Friday with a turn-around-time of 1-3 days. Results will be reported qualitatively as Immune or Not Immune. If quantitative results are needed, please fax Immunochemistry at 616-267-2771 or call 616-267-2770.