Contamination of a neonate's red blood cells with Wharton's jelly can result in aggregates that can resemble agglutinates in red cell typing or antibody testing.


Only a small amount of Wharton's jelly is needed to cause the effect.


Clinical findings:

(1) The umbilical cord may have an increase in the amount of Wharton's jelly, resulting in an increased diameter to the cord.

(2) The blood sample typically has been collected by squeezing the end of the cut umbilical cord into a tube.

(3) The aggregates disappear on treating the blood with hyaluronidase.


The chances of this occurring are much lower if the blood is collected from the umbilical vein using a needle and syringe.


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