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Choosing Wisely Perinatal Recommendations

Choosing Wisely Canada, in collaboration with the CSTM Canadian Obstetrics and Pediatric Transfusion Network (COPTN), has released the CSTM’s four new Perinatal recommendations. 

The COPTN ​compiled its Choosing Wisely Canada list of recommendations by putting out a call to its membership for suggested list items. ​The chairs of COPTN compiled these suggestions and developed the rationale and references. These statements and rationale were presented virtually to the COPTN committee who ranked the suggestions according to their importance and refined the wording and the order of the item lists.

The Canadian Obstetrical Pediatric Transfusion Network (COPTN) is a sub-committee of the CSTM. It was founded in 2017 and its mandate is to assess, analyze and strive to implement best practices in pediatric and obstetrical transfusion practice in Canada.


Avoid routinely performing direct antiglobulin test on all neonatal cord samples.

The DAT is not a screening test for hyperbilirubinemia or hemolytic disease. Routine assessment of the DAT may reveal cases of ABO incompatibility which are clinically insignificant; conversely the DAT may fail to identify significant hemolysis due to non immune causes. The DAT should be performed only when anemia or hyperbilirubinemia is suspected or when maternal alloantibodies are present.