Do chorionic villus samplings (CVS) or amniocenteses (AC) induce RhD immunisation? An evaluation of a large Danish cohort with no routine administration of anti-D after invasive prenatal testing.
Adult
Amniocentesis
/ adverse effects
Chorionic Villi Sampling
/ adverse effects
Cohort Studies
Databases, Factual
Denmark
Female
Gestational Age
Humans
Pregnancy
Pregnancy Complications, Hematologic
/ diagnosis
Prenatal Diagnosis
/ adverse effects
Retrospective Studies
Rh Isoimmunization
/ etiology
Rho(D) Immune Globulin
/ immunology
Risk
Young Adult
prenatal invasive testing
rhesus immunisation
rhesus prophylaxis
Journal
BJOG : an international journal of obstetrics and gynaecology
ISSN: 1471-0528
Titre abrégé: BJOG
Pays: England
ID NLM: 100935741
Informations de publication
Date de publication:
Nov 2019
Nov 2019
Historique:
accepted:
25
06
2019
pubmed:
10
7
2019
medline:
17
10
2019
entrez:
9
7
2019
Statut:
ppublish
Résumé
To evaluate the risk of inducing RhD immunisation in pregnancies of RhD-negative mothers with an RhD-positive fetus undergoing chorionic villus samplings (CVS) or amniocenteses (AC). Registry-based study in a Danish cohort which has not been given rhesus prophylaxis. Data were retrieved from the Department of Clinical Immunology at Rigshospitalet. All RhD-negative women carrying an RhD-positive fetus with screen test results from weeks 8-12 and weeks 25-29 were linked to data from the Danish Fetal Medicine Database. Data were divided into cases where no invasive prenatal diagnostic procedure was performed, cases that had AC performed, and cases that had CVS performed. A comparison of the proportion of women who developed RhD immunisation between the two screen tests. The cohort consisted of 10 085 women: 9353 had no invasive procedures performed, 189 had AC and 543 had CVS performed. No women were immunised spontaneously or due to the procedure between the first and second screen test in the group with no procedure performed, or in the AC group. One woman was immunised in the CVS group. When comparing the proportion of women who was immunised in the CVS group with the no invasive test group a non-significant difference was found (P = 0.055). The RhD immunisation rate before gestational weeks 25-29 in RhD-negative women carrying an RhD-positive fetus is very low, even in women undergoing prenatal invasive testing without rhesus prophylaxis. The RhD immunisation rate during pregnancy is very low even in women undergoing prenatal invasive testing.
Identifiants
pubmed: 31283084
doi: 10.1111/1471-0528.15861
doi:
Substances chimiques
RHO(D) antibody
0
Rho(D) Immune Globulin
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1476-1480Commentaires et corrections
Type : CommentIn
Informations de copyright
© 2019 Royal College of Obstetricians and Gynaecologists.
Références
van der Schoot CE, de Haas M, Clausen FB. Genotyping to prevent Rh disease: has the time come? Curr Opin Hematol 2017;24:544-50.
FØTO-Sandbjerg guideline on CVS and AC [Internet]. [cited 2017 July 11]. Available from: http://www.dfms.dk/images/Guidelines/guideline-CVS-og-AC-091215.pdf
Guidelines for the use of Rh(D) immunoglobulin (Anti-D) in obstetrics in Australia [Internet]. [cited 2017 July 11]. Available from: https://www.ranzcog.edu.au/RANZCOG_SITE/media/RANZCOG-MEDIA/Women%27s%20Health/Statement%20and%20guidelines/Clinical-Obstetrics/Guidelines-for-the-use-of-Rh(D)-Immunoglobulin-(Anti-D)-(C-Obs-6)-Review-November-2015.pdf?ext=.pdf
Green-top Guideline No. 8 on Amniocentesis and Chorionic Villus Sampling [Internet]. [cited 2017 July 11]. Available from: https://www.rcog.org.uk/globalassets/documents/guidelines/gtg_8.pdf
SOGC Clinical Practice Guidelines on Prevention of Rh Alloimmunization [Internet]. [cited 2017 July 11]. Available from: https://sogc.org/wp-content/uploads/2013/01/133E-CPG-September2003.pdf
Smidt-Jensen S, Philip J, Zachary JM, Fowler SE, Nørgaard-Pedersen B. Implications of maternal serum alpha-fetoprotein elevation caused by transabdominal and transcervical CVS. Prenat Diagn 1994;14:35-45.
Meleti D, De Oliveira LG, Araujo Júnior E, Caetano ACR, Boute T, Nardozza LMM, et al. Evaluation of passage of fetal erythrocytes into maternal circulation after invasive obstetric procedures. J Obstet Gynaecol Res 2013;39:1374-82.
Subirá D, Uriel M, Serrano C, Castañón S, Gonzalo R, Illán J, et al. Significance of the volume of fetomaternal hemorrhage after performing prenatal invasive tests. Cytometry B Clin Cytom 2011;80:38-42.
Pelikan DM, Kanhai HH, De Groot-Swings GM, Mesker WE, Tanke HJ, Scherjon SA. Fetomaternal hemorrhage in relation to chorionic villus sampling revisited. Prenat Diagn 2006;26:201-5.
Al-Mufti R, Hambley H, Farzaneh F, Nicolaides KH. Distribution of fetal erythroblasts in maternal blood after chorionic villous sampling. BJOG 2003;110:33-8.
Tabor A, Bang J, Nørgaard-Pedersen B. Feto-maternal haemorrhage associated with genetic amniocentesis: results of a randomized trial. Br J Obstet Gynaecol 1987;94:528-34.
Brambati B, Guercilena S, Bonacchi I, Oldrini A, Lanzani A, Piceni L. Feto-maternal transfusion after chorionic villus sampling: clinical implications. Hum Reprod Oxf Engl 1986;1:37-40.
Tabor A, Jerne D, Bock JE. Incidence of rhesus immunisation after genetic amniocentesis. Br Med J Clin Res Ed 1986;293:533-6.
Sundhedsstyrelsens Anbefalinger for Svangreomsorgen 2013, 9.2 [Internet]. [cited 2017 July 11]. Available from: https://sundhedsstyrelsen.dk/da/sundhed/~/media/D76304BDB11F48BBB1E83CBC8E0AD85B.ashx
Ekelund CK, Kopp TI, Tabor A, Petersen OB. The Danish Fetal Medicine database. Clin Epidemiol 2016;8:479-83.
rhesonativinj.pdf [Internet]. [cited 2017 Jul 21]. Available from: http://www.medsafe.govt.nz/profs/datasheet/r/rhesonativinj.pdf
https://www.sundhed.dk/sundhedsfaglig/laegehaandbogen/obstetrik/tilstande-og-sygdomme/risikofaktorer-i-svangerskabet/rhd-rhesus-immunisering/