Clinical utility of fetal RhD typing in alloimmunized pregnancies by means of polymerase chain reaction on amniocytes or chorionic villi.
OBJECTIVE
Our purpose was to describe the clinical utility of a deoxyribonucleic acid amplification method for determining fetal RhD status in alloimmunized pregnancies


METHODS
Six RhD-negative women with alloimmunized pregnancies and heterozygous partners underwent amniocentesis (n = 5) or chorionic villus sampling (n = 1). Fetal RhD type was determined by polymerase chain reaction and results disclosed to the attending physicians.


RESULTS
Knowledge of the fetal RhD status avoided further invasive procedures in two pregnancies and facilitated the timing or performance of intrauterine transfusions in the remainder.


CONCLUSIONS
In alloimmunized pregnancies the ability to RhD-type the fetus in amniotic fluid avoids the risks of fetomaternal hemorrhage and increased sensitization associated with fetal blood sampling or chorionic biopsy. This allows more rational pregnancy management, avoiding invasive procedures in the presence of an RhD-negative fetus, or planning therapeutic interventions or offering termination of pregnancy in the presence of an RhD-positive fetus.
Royal Postgraduate Medical School, Institute of Obstetrics and Gynaecology, Queen Charlotte's and Chelsea Hospital, London, United Kingdom.
N M
NM
Fisk
P
P
Bennett
R M
RM
Warwick
E A
EA
Letsky
R
R
Welch
J I
JI
Vaughan
G
G
Moore
D000653:Amniotic Fluid / Q000166:cytology / Q000276:immunology; D001483:Base Sequence; D001788:Blood Grouping and Crossmatching / Q000379:methods*; D002824:Chorionic Villi / Q000276:immunology; D004899:Erythroblastosis, Fetal / Q000175:diagnosis*; D005260:Female; D005312:Fetal Blood / Q000166:cytology / Q000276:immunology*; D006801:Humans; D007231:Infant, Newborn; D008969:Molecular Sequence Data; D016133:Polymerase Chain Reaction; D011247:Pregnancy; D011248:Pregnancy Complications / Q000276:immunology; D011296:Prenatal Diagnosis; D012203:Rh Isoimmunization; D012204:Rh-Hr Blood-Group System / Q000032:analysis*
D012204:Rh-Hr Blood-Group System