Terminating Routine Cord Blood RhD Typing of the Newborns to Guide Postnatal Anti-D Immunoglobulin Prophylaxis Based on the Results of Fetal RHD Genotyping.
Alloimmunization
Cord blood RhD typing
Fetal RHD genotyping
Noninvasive prenatal diagnosis
Red cell alloimmunization
Rhesus alloimmunization
Journal
Fetal diagnosis and therapy
ISSN: 1421-9964
Titre abrégé: Fetal Diagn Ther
Pays: Switzerland
ID NLM: 9107463
Informations de publication
Date de publication:
2023
2023
Historique:
received:
14
03
2023
accepted:
09
06
2023
medline:
4
10
2023
pubmed:
29
6
2023
entrez:
28
6
2023
Statut:
ppublish
Résumé
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. 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. 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%. 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.
Identifiants
pubmed: 37379821
pii: 000531694
doi: 10.1159/000531694
pmc: PMC10614222
doi:
Substances chimiques
RHO(D) antibody
0
Rh-Hr Blood-Group System
0
Rho(D) Immune Globulin
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
276-281Informations de copyright
© 2023 The Author(s). Published by S. Karger AG, Basel.
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