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Determination of fetal RHD type in plasma of RhD negative pregnant women

Sørensen, Kirsten; Kjeldsen-Kragh, Jens LU ; Husby, Henrik and Akkök, Çiğdem Akalın (2018) In Scandinavian Journal of Clinical and Laboratory Investigation 78(5). p.411-416
Abstract

Alloimmunization against the RhD antigen is the most common cause of hemolytic disease of the fetus and newborn. Antenatal anti-D prophylaxis in addition to postnatal anti-D prophylaxis reduces the number of RhD-immunizations compared to only postnatal administration. Cell-free fetal DNA released from the apoptotic trophoblastic placental cells into the maternal circulation can be used to determine the fetal RHD type in a blood sample from an RhD negative mother. Based on this typing, antenatal anti-D prophylaxis can be recommended only to RhD negative women carrying an RhD positive fetus, since only these women are at risk of developing anti-D. The objective was to establish and validate a method for non-invasive fetal RHD typing. The... (More)

Alloimmunization against the RhD antigen is the most common cause of hemolytic disease of the fetus and newborn. Antenatal anti-D prophylaxis in addition to postnatal anti-D prophylaxis reduces the number of RhD-immunizations compared to only postnatal administration. Cell-free fetal DNA released from the apoptotic trophoblastic placental cells into the maternal circulation can be used to determine the fetal RHD type in a blood sample from an RhD negative mother. Based on this typing, antenatal anti-D prophylaxis can be recommended only to RhD negative women carrying an RhD positive fetus, since only these women are at risk of developing anti-D. The objective was to establish and validate a method for non-invasive fetal RHD typing. The fetal RHD genotype was studied in 373 samples from RhD negative pregnant women (median gestational week 24). DNA extracted from plasma was analyzed for the presence/absence of RHD exon 7 and 10 in a real-time PCR. The RHD genotype of the fetus was compared with the serological RhD type of the newborn. In 234 samples, the fetal RHD test was positive and in 127 samples negative. There was one false positive and no false negative results. In 12 samples, the fetal RHD type could not be determined, in all of them due to a maternal RHD gene. This method gives a reliable detection of fetal RHD positivity in plasma from RhD negative pregnant women. Antenatal anti-D prophylaxis based on the predicted fetal RhD type will avoid unnecessary treatment of pregnant women carrying an RhD negative fetus.

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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
blood typing, DNA, fetus, genotyping, immunization, newborn, pregnancy, prenatal diagnosis/methods, real-time polymerase chain reaction, RHO(D) antibody, Rho(D) Immune Globulin
in
Scandinavian Journal of Clinical and Laboratory Investigation
volume
78
issue
5
pages
411 - 416
publisher
Informa Healthcare
external identifiers
  • scopus:85048061694
ISSN
0036-5513
DOI
10.1080/00365513.2018.1475681
language
English
LU publication?
yes
id
82ddcd68-e0c9-45dd-8ec2-b7d49404ae0f
date added to LUP
2018-06-19 12:53:59
date last changed
2019-02-03 05:33:28
@article{82ddcd68-e0c9-45dd-8ec2-b7d49404ae0f,
  abstract     = {<p>Alloimmunization against the RhD antigen is the most common cause of hemolytic disease of the fetus and newborn. Antenatal anti-D prophylaxis in addition to postnatal anti-D prophylaxis reduces the number of RhD-immunizations compared to only postnatal administration. Cell-free fetal DNA released from the apoptotic trophoblastic placental cells into the maternal circulation can be used to determine the fetal RHD type in a blood sample from an RhD negative mother. Based on this typing, antenatal anti-D prophylaxis can be recommended only to RhD negative women carrying an RhD positive fetus, since only these women are at risk of developing anti-D. The objective was to establish and validate a method for non-invasive fetal RHD typing. The fetal RHD genotype was studied in 373 samples from RhD negative pregnant women (median gestational week 24). DNA extracted from plasma was analyzed for the presence/absence of RHD exon 7 and 10 in a real-time PCR. The RHD genotype of the fetus was compared with the serological RhD type of the newborn. In 234 samples, the fetal RHD test was positive and in 127 samples negative. There was one false positive and no false negative results. In 12 samples, the fetal RHD type could not be determined, in all of them due to a maternal RHD gene. This method gives a reliable detection of fetal RHD positivity in plasma from RhD negative pregnant women. Antenatal anti-D prophylaxis based on the predicted fetal RhD type will avoid unnecessary treatment of pregnant women carrying an RhD negative fetus.</p>},
  author       = {Sørensen, Kirsten and Kjeldsen-Kragh, Jens and Husby, Henrik and Akkök, Çiğdem Akalın},
  issn         = {0036-5513},
  keyword      = {blood typing,DNA,fetus,genotyping,immunization,newborn,pregnancy,prenatal diagnosis/methods,real-time polymerase chain reaction,RHO(D) antibody,Rho(D) Immune Globulin},
  language     = {eng},
  month        = {06},
  number       = {5},
  pages        = {411--416},
  publisher    = {Informa Healthcare},
  series       = {Scandinavian Journal of Clinical and Laboratory Investigation},
  title        = {Determination of fetal RHD type in plasma of RhD negative pregnant women},
  url          = {http://dx.doi.org/10.1080/00365513.2018.1475681},
  volume       = {78},
  year         = {2018},
}