Browsing Tag

Obstetrics & Gynecology

General Information, Hematology

Update: Complete Blood Count (CBC)

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. Continue Reading

General Information, Toxicology

Update: Meconium Drug Testing

Effective November 21, 2022, the following changes will be made to Meconium Drug Testing (LAB479).

  1. 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.
  2. 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.

Continue Reading

Advanced Technology Laboratory, Cytogenetics

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

• Williams (7q11,23) 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. Continue Reading

General Information, Microbiology, Test Utilization

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.

Tissue Culture (LAB2111173)

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.

Advanced Technology Laboratory, Molecular Diagnostics

Test Discontinuation: MTHFR C677T

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. Continue Reading

Chemistry, General Information, Immunochemistry

Test Update: Rubella IgG Antibody Testing

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. Continue Reading