Routine noninvasive prenatal screening for fetal Rh D in maternal plasma—A 2‐year experience from a single center in Belgium

Blomme, Siska; Nollet, Friedel; Rosseel, Wesley; Bogaard, Natalie; Devos, Helena; Emmerechts, Jan; Cauwelier, Bárbara

doi:10.1111/trf.16868

Cited by 3 publications

(1 citation statement)

References 26 publications

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“…The Stockholm area in Sweden, where fetal RHD genotyping is based on a single exon (exon 4) and performed from GW10, discontinued serologic RhD typing of the newborns in 2020 after 10 years [7]. Sensitivity of our assays (99.93%) in all health regions was also very high and similar to reports by other groups [4,[6][7][8][9][10][11][12][13][14][15], while specificity was 99.24%.…”

Section: Discussionsupporting

confidence: 79%

Terminating Routine Cord Blood RhD Typing of the Newborns to Guide Postnatal Anti-D Immunoglobulin Prophylaxis Based on the Results of Fetal RHD Genotyping

Stensrud,

Bævre,

Alm

et al. 2023

Fetal Diagn Ther

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Introduction: Targeted routine antenatal prophylaxis with anti-D immunoglobulin (Ig) only to RhD-negative pregnant women who carry RhD-positive fetuses (determined by fetal RHD genotyping) has reduced D-alloimmunization significantly when administered in addition to postnatal prophylaxis. Achieving high analysis sensitivity and few false-negative fetal RHD results will make RhD typing of the newborn redundant. Postnatal prophylaxis can then be given based on the result of fetal RHD genotyping. Terminating routine RhD typing of the newborns in cord blood will streamline maternity care. Accordingly, we compared the results of fetal RHD genotyping with RhD typing of the newborns. Methods: Fetal RHD genotyping was performed, and antenatal anti-D Ig was administered at gestational week 24 and 28, respectively. Data for 2017–2020 are reported. Results: Ten laboratories reported 18,536 fetal RHD genotypings, and 16,378 RhD typing results of newborns. We found 46 false-positive (0.28%) and seven false-negative (0.04%) results. Sensitivity of the assays was 99.93%, while specificity was 99.24%. Conclusion: Few false-negative results support the good analysis quality of fetal RHD genotyping. Routine cord blood RhD typing will therefore be discontinued nationwide and postnatal anti-D Ig will now be given based on the result of fetal RHD genotyping.

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Section: Discussionsupporting

confidence: 79%

Terminating Routine Cord Blood RhD Typing of the Newborns to Guide Postnatal Anti-D Immunoglobulin Prophylaxis Based on the Results of Fetal RHD Genotyping

Stensrud,

Bævre,

Alm

et al. 2023

Fetal Diagn Ther

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

Schoot

Oepkes

2023

Prenatal Diagnostic Testing for Genetic Disorders

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Internationale richtlijnen voor het gebruik van Rhesus D immunoglobuline: een vergelijkend onderzoek en de plaats van foetale Rhesus D genotypering

Depaepe¹,

Oostrum²,

Roets³

et al. 2023

Tijdschr Geneesk

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International guidelines for the use of Rhesus D immunoglobulin: a comparative study and the contribution of fetal Rhesus genotyping The introduction of immunoglobulin D (Anti-D, Rhogamâ) has been a major advancement in the prevention of Rhesus D alloimmunisation. However, the required dose and timing of administration remain unclear. Fetal Rhesus genotyping, to administer Anti-D more selectively, is not yet available as part of standard care for Rhesus negative pregnant women in Belgium. We performed a comparative literature search, using the most recent international guidelines regarding the use of Anti-D and fetal Rhesus genotyping. There is international consensus that Anti-D should be administered prophylactically between 28-34 weeks of gestation and especially postpartum. The recommended dose and number of administrations vary strongly in different countries. There is no international consensus regarding the necessity to administer Anti-D nor the dose of Anti-D to be administered in the event of possible sensitisation during pregnancy. The results of our guideline study suggest that several possible causes of sensitisation require a lower dose of Anti-D than the currently available dose in Belgium (1500 IU). One could consider introducing a lower dose in Belgium in order to use Anti-D more efficiently. Nonetheless, further research concerning the ideal dose per indication and the ideal timing of administration is indicated. Fetal Rhesus D genotyping has a sensitivity of 99.9% and specificity of 99.2% when performed after 11 weeks of gestation. Given the high sensitivity and specificity of fetal Rhesus genotyping, a standard implementation of this test in Belgium certainly seems worth considering.

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Routine noninvasive prenatal screening for fetal Rh D in maternal plasma—A 2‐year experience from a single center in Belgium

Cited by 3 publications

References 26 publications

Terminating Routine Cord Blood RhD Typing of the Newborns to Guide Postnatal Anti-D Immunoglobulin Prophylaxis Based on the Results of Fetal RHD Genotyping

Terminating Routine Cord Blood RhD Typing of the Newborns to Guide Postnatal Anti-D Immunoglobulin Prophylaxis Based on the Results of Fetal RHD Genotyping

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

Internationale richtlijnen voor het gebruik van Rhesus D immunoglobuline: een vergelijkend onderzoek en de plaats van foetale Rhesus D genotypering

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