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Lessons learned from the implementation of non-invasive fetal RHD screening

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  3. Noninvasive fetal RHD genotyping to guide targeted anti-D prophylaxis-an external quality assessment workshop

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  4. Noninvasive Antenatal Screening for Fetal RHD in RhD Negative Women to Guide Targeted Anti-D Prophylaxis

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INTRODUCTION: In the fight against hemolytic disease of the fetus and newborn, pregnant RhD negative women are offered antenatal and postnatal anti-D immunoglobulin prophylaxis to prevent the development of antibodies against the fetal D antigen. Antenatal prophylaxis has traditionally been provided to all D negative pregnant women, as the fetal RhD type remains unknown until birth. With noninvasive prenatal testing of cell-free DNA, predicting the fetal RhD type has become highly feasible based on analysis of the fetal RHD gene. Fetal RHD screening can guide targeted antenatal prophylaxis, treating only women who carry an RhD positive fetus, thereby avoiding the unnecessary treatment of approximately 40% of the RhD negative women. Areas covered: Areas covered are the current clinical practice, performance, and challenges of fetal RHD screening, and relevant issues for its implementation. Expert commentary: Fetal RHD screening is highly accurate, with sensitivities of 99.9%, as reported from clinical programs. From gestational week 10, sensitivities are approximately 99%. Despite challenges in assay design, low levels of cell-free fetal DNA in the maternal plasma, and concerns regarding implementation and medical necessity, the clinical experience with fetal RHD screening and targeted prophylaxis has generated encouraging results, and its future widespread use is expected.

Original languageEnglish
JournalExpert Review of Molecular Diagnostics
Volume18
Issue number5
Pages (from-to)423-431
Number of pages9
ISSN1473-7159
DOIs
Publication statusPublished - May 2018

ID: 55401044