During normal vaginal delivery as well as during delivery by cesarean section, FMH of less than 5 mL occurs in the great majority of cases, and thus for the prevention of D alloimmunization, an IgG anti-D dose of 100 µg should be sufficient. Contrarily, only rarely does greater FMH occur and delivery by cesarean section does not present a risk factor.
Background: The clinical importance of assessing the fetal KEL genotype is to exclude ‘K'-positive fetuses (genotype KEL1/KEL2) in ‘K'-alloimmunized pregnant women (genotype KEL2/KEL2). Noninvasive assessment of the fetal KEL genotype is not yet available in the Czech Republic. Objective: The aim of this study was to assess the fetal KEL1/KEL2 genotype from cell-free fetal DNA in the plasma of KEL2/KEL2 pregnant women. Methods: The fetal genotype was assessed by minisequencing (a dilution series including control samples). A total of 138 pregnant women (between the 8th and 23rd gestational week) were tested by minisequencing. The fetal genotype was further verified by analysis of a buccal swab from the newborn. Results: Minisequencing proved to be a reliable method. In 2.2% (3/138) of the examined women, plasma sample testing failed; 94.8% (128/135) had the KEL2/KEL2 genotype, and a total of 3.1% of fetuses (4/128) had the KEL1/KEL2 genotype. Sensitivity and specificity reached 100% (p < 0.0001). Conclusion: Minisequencing is a reliable method for the assessment of the fetal KEL1 allele from the plasma of KEL2/KEL2 pregnant women.
, Martin Prochazka aAims. The aim of this study was to assess the feasibility and accuracy of fetal gender assignment by transabdominal ultrasound at 12-14 weeks of gestation. Methods. Fetal gender assessment was performed in 1222 singleton pregnancies. In all fetuses the crown-rump length (CRL) was measured and the genital area of the fetus was examined in the mid-sagittal plane. The result of ultrasound examination was compared to the phenotypic sex of the newborn after delivery. Results. The feasibility as well as accuracy in determining gender increased with growing fetal CRL. At CRL < 50 mm (gestational age < 11+4) the feasibility was 39.1% and accuracy 30.5% (40.9% in male gender vs 24.3% in female gender). At CRL 50-54.9 mm (gestational age 11+4 to 12+0) the feasibility was 63.5% and accuracy 75.0% (89.1% in male gender vs 66.7% in female gender). At CRL 55-59.9 mm (gestational age 12+0 to 12+2) the feasibility was 90.5% and accuracy 96.6% (99.1% in male gender vs 93.5% in female gender). At CRL ≥ 60 mm (gestational age ≥ 12+2) the feasibility was 97.4% and accuracy 100.0% (100.0% in male gender vs 100.0% in female gender). Conclusions. Fetal gender may reliably be determined when CRL ≥ 60 mm (gestational age ≥ 12+2). Male gender may already be reliably determined when CRL ≥ 55 mm (gestational age ≥ 12+0). If CRL < 50 mm (gestational age < 11+4) the gender cannot be reliably predicted.
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