title: Reliable Determination of Fetal RhD Status by RHD Genotyping from Maternal Plasma.
abstract: BACKGROUND
  Immunoprophylaxis with IgG anti-D is a standard prevention of hemolytic disease of the fetus and newborn. Fetal Rhesus D (RhD) blood group genotyping from maternal plasma of RhD-negative pregnant women allows targeted prophylaxis with IgG anti-D in RhD-positive pregnancies only. We set up a reliable protocol for prenatal RHD genotyping.
  
  
  METHODS
  153 pregnant Caucasian RhD-negative women were tested in the 27th week (range 7-38th week) of pregnancy. 18 of them were alloimmunized to the RhD antigen. The fetal RHD genotype was determined based on an automated DNA extraction and real-time polymerase chain reaction method. Intron 4 and exons 5, 7 and 10 of the RHD gene and the SRY gene were targeted.
  
  
  RESULTS
  The fetal RhD status and gender was 100% correctly predicted in all 153 pregnancies (55 RhD-positive males, 45 RhD-positive females; 23 RhD-negative males, 30 RhD-negative females).
  
  
  CONCLUSIONS
  The accuracy and applicability of our protocol for non-invasive fetal RhD determination allows the correct management of RhD-incompatible pregnancies. Our protocol could prevent unnecessary immunoprophylaxis in 53 of 153 cases. We therefore recommend that non-invasive fetal RHD genotyping is introduced as an obligatory part of prenatal screening.
authors: Blood Transfusion Center of Slovenia, University Medical Center, Ljubljana, Slovenia.
authors: Tadeja
authors: T
authors: Dovč-Drnovšek
authors: Polona
authors: P
authors: Klemenc
authors: Nataša
authors: N
authors: Toplak
authors: Tanja
authors: T
authors: Blejec
authors: Irena
authors: I
authors: Bricl
authors: Primož
authors: P
authors: Rožman
keywords: Fetal DNA; Maternal plasma; Noninvasive RHD typing
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