Cell free DNAs (cfDNA) are short DNA fragments which are present in all biological fluids and cell culture medium. They were first detected in blood plasma by Mandel and Metais in 1948. cfDNAs are mostly endogenous-derived fragments that are determined in lipid/protein rich complexes or particles with membranes. In healthy individuals, there are small amounts of mono-nucleosome forms of cfDNA in the peripheral circulation. cfDNA can bind to proteins and phospholipids on cell surfaces. This mechanism may related to absorbance and release of cfDNA. Different enzymes such as deoxyribonuclease (DNase) may facilitate the unbounding and recirculation of membrane bound cfDNAs.
The detection of cell-free fetal DNA (cffDNA) from maternal plasma has enabled the development of essential prenatal diagnostic techniques supporting the non-invasive screening and diagnostic tests in recent years.We performed a non-invasive real-time polymerase chain reaction (PCR) using cell-free DNA isolated from the peripheral blood of pregnant women to determine fetal Rhesus D (RhD) and sex. Consistent with the findings of similar studies, our results revealed high accuracy rates of PCR in determining fetal RhD, making it suitable for diagnostic use, thereby indicating its effectiveness as a guide in treating and especially in minimizing the procedures applied to pregnant women who are RhD negative.This study compared the cost incurred between follow-up testing and treatment of RhD (-) pregnant women and the fetal RHD genotyping based on Health Implementation Notification (SUT) data of the Social Security Administration of the Republic of Turkey. Additionally, the role of PCR to the diagnostic process was evaluated.Our results showed that fetal RHD genotyping costs 523.19 TL (3.5 times) less for each RhD (-) pregnant women compared with the current additional tests and treatments. PCR with cffDNA is an innovative method that minimizes workload, hospital costs, and unnecessary tests and treatment. In addition, this method allows an early initiation of treatment and avoidance of unnecessary intervention and cost.
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