Fetal RHD detection in early pregnancy using a single-exon assay in a routine clinical setting is feasible and accurate
More information about early fetal RHD screening using a single-exon assay is available in the study “Noninvasive single-exon fetal RHD determination in a routine screening program in early pregnancy“. The objective of the study was to develop a simple and robust assay suitable for fetal RHD screening in first-trimester pregnancy and to estimate the sensitivity and specificity of the test after its implementation in an unselected pregnant population. The study included pregnant women attending their first antenatal visit, and fetal RHD determination was performed for all women who typed RhD–negative by routine serology. DNA was extracted by an automated system and quantitative polymerase chain reaction was done by an assay based on exon 4. The study found that both sensitivity and specificity were close to 99%, provided samples were not collected before gestational week 8. It concludes that fetal RHD detection in early pregnancy using a single-exon assay in a routine clinical setting is feasible and accurate.
Agneta Taune Wikman, Eleonor Tiblad, Anita Karlsson, Martin L Olsson, Magnus Westgren, Marie Reilly, Obstet Gynecol 2012 Aug; 120(2 Pt 1):227-34.
Fetal RHD screening and targeted prophylaxis resulted in lower immunisation risk and costs compared with no RAADP
The cost-effectiveness of the method has been examined in another study, “Cost-effectiveness of first trimester non-invasive fetal RHD screening for targeted antenatal anti-D prophylaxis in RhD-negative pregnant women: a model-based analysis”.The objective was to estimate the cost-effectiveness of first trimester non-invasive fetal RHD screening for targeted antenatal versus no routine antenatal anti-D prophylaxis (RAADP) or versus non-targeted RAADP. The study concluded that based on effect data from a population-based cohort study, targeted prophylaxis was associated with lower immunisation risk and costs versus no RAADP. Based on effect data from theoretical calculations, non-targeted RAADP was predicted to result in lower costs and immunisation risk compared with targeted prophylaxis.
M Neovius, E Tiblad, M Westgren, M Kublickas, K Neovius, A Wikman, BJOG. 2016 Jul;123(8):1337-46.