The determination of the fetal D status from maternal plasma for decision making on Rh prophylaxis is feasible

Müller, S; Bartels, Iris; Stein, W.; Emons, G.; Gutensohn, K.; Köhler, Michael; Legler, Tobias J.

doi:10.1111/j.1537-2995.2008.01843.x

Cited by 105 publications

(139 citation statements)

References 43 publications

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“…The same approach, which allows more standardised processing, has successfully been used before for the determination of fetal RhD status in pregnant women. 17 The results of the present study show that the same automated and standardised approach is also applicable to C, c and E testing.…”

Section: Discussionmentioning

confidence: 56%

“…The method has been used effectively to determine fetal sex, and since 2001 a molecular diagnostic service for fetal RHD genotyping has existed in the UK. 8,9,17 Testing for the prediction of C, c, E and Kell phenotypes has also been performed. [12][13][14][15] As early analysis during pregnancy allows timely and effective clinical treatment, we focused on women in early pregnancy (median 16 weeks of gestation).…”

Section: Discussionmentioning

confidence: 99%

“…[12][13][14][15][16] DNA testing earlier in pregnancy has now been established for RhD determination. 17 However, as data are lacking, there is a need to investigate rhesus CcEe (RHCE) alleles in a large study population in early second trimester.…”

Section: Introductionmentioning

confidence: 99%

“…17 The aims of the study were to determine the accuracy of fetal C, c and E typing in early pregnancy, and to compare the sensitivities and specificities of the two PCR protocols.…”

Section: Introductionmentioning

confidence: 99%

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Diagnostic accuracy of noninvasive polymerase chain reaction testing for the determination of fetal rhesus C, c and E status in early pregnancy

Gutensohn¹,

Müller

Thomann

et al. 2010

BJOG

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Objective The aim of the study was to determine the sensitivity, specificity and accuracy of noninvasive tests for the fetal rhesus CcEc (RHCE) alleles C, c and E in early pregnancy.Design A prospective clinical trial was carried out to evaluate diagnostic accuracy.Setting Women were recruited at four centres specialising in prenatal diagnosis. Peripheral blood and amniotic fluid samples were obtained and sent to a single laboratory for analysis.Sample A total of 233 tests (46 for C, 87 for c and 100 for E) were performed on 181 specimens obtained from pregnant women at weeks 12 to 28 (median week 16) of gestation.Methods Following automated extraction of fetal DNA from maternal plasma, two different real-time polymerase chain reaction (PCR) protocols were used for the detection of the C, c and E alleles of RHCE. The results of the PCR were compared with genotyping results for the amniotic fluid.Main outcome measures Failure rate, sensitivity, specificity and accuracy were the main outcome measures.Results Unequivocal results were obtained for all specimens. With the first PCR protocol, the sensitivity was 100% for C, 38% for c and 59% for E. In contrast, with the second protocol, the sensitivity for C, c and E was 100%. The specificity for all assays was found to be between 99% and 100%.Conclusions A highly accurate protocol has been identified for the detection of fetal RHCE alleles in maternal plasma in early pregnancy. This noninvasive approach can be considered as a useful test in the management of pregnancies with anti-c, anti-E or anti-C alloimmunisation.

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Section: Discussionmentioning

confidence: 56%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

“…17 The aims of the study were to determine the accuracy of fetal C, c and E typing in early pregnancy, and to compare the sensitivities and specificities of the two PCR protocols.…”

Section: Introductionmentioning

confidence: 99%

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Diagnostic accuracy of noninvasive polymerase chain reaction testing for the determination of fetal rhesus C, c and E status in early pregnancy

Gutensohn¹,

Müller

Thomann

et al. 2010

BJOG

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“…Cell-free fetal DNA from maternal blood is tested for the presence or absence of the RhD gene, and results are used to direct management of the pregnancy. Several studies have confirmed the safety and high diagnostic accuracy of this approach (6)(7)(8)(9)(10). Fetal RhD genotyping was found to be sufficiently accurate to be used from 11 weeks' gestation (3).…”

Section: Introductionmentioning

confidence: 91%

Is the management of Rh-Rh incompatibility with noninvasive fetal Rh genotypingfor targeted prophylaxis cost-effective in the Turkish population?

Demirel¹,

Kelekçi²,

Ekmekçi³

et al. 2018

Turk J Med Sci

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The aim of this study was to assess unnecessary immunization rates and compare the cost-effectiveness of targeted prophylaxis with fetal Rh genotyping with that of traditional management of Rh-Rh incompatibility in a virtual economic model. Materials and methods:This retrospective data analysis was conducted at two tertiary centers between 2011 and 2015. The data of 1135 pregnant women were analyzed. The main outcome measure was to determine the unnecessary immunization rate among the whole Rh-Rh incompatibility group. The second outcome measure was to compare the cost-effectiveness of universal immunization with that of targeted prophylaxis with fetal Rh genotyping in a virtual economic model. Results:Average cost per patient was found as $259.20 with universal prophylaxis and the total cost was $177,344, whereas if targeted prophylaxis had been applied to these patients the total cost would have been $263,392 and cost per patient would have been $385. Universal prophylaxis was more cost-effective than targeted prophylaxis in terms of both total cost and cost per patient (P < 0.0001). Conclusion:Unless the cost of noninvasive fetal Rh genotyping is reduced, a universal approach of anti-D immune globulin prophylaxis is more cost-effective than noninvasive determination of fetal Rh genotyping with targeted prophylaxis.

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Noninvasive Prenatal Screening and Diagnosis Using Cell‐free Fetal DNA

Hill

Chitty

2015

Genetic Disorders and the Fetus

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The determination of the fetal D status from maternal plasma for decision making on Rh prophylaxis is feasible

Abstract: This prospective clinical trial revealed that routine determination of the fetal D status from maternal plasma is feasible. Noninvasive fetal RHD genotyping can be considered as sensitive as the traditional postnatal serologic assay.

Cited by 105 publications

References 43 publications

Diagnostic accuracy of noninvasive polymerase chain reaction testing for the determination of fetal rhesus C, c and E status in early pregnancy

Diagnostic accuracy of noninvasive polymerase chain reaction testing for the determination of fetal rhesus C, c and E status in early pregnancy

Is the management of Rh-Rh incompatibility with noninvasive fetal Rh genotypingfor targeted prophylaxis cost-effective in the Turkish population?

Noninvasive Prenatal Screening and Diagnosis Using Cell‐free Fetal DNA

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