Blood Transfusion Center of Slovenia, University Medical Center, Ljubljana, Slovenia.
Transfus Med Hemother. 2013 Feb;40(1):37-43. doi: 10.1159/000345682. Epub 2013 Jan 3.
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.
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.
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).
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.
免疫球蛋白 G（IgG）抗-D 免疫预防是预防胎儿和新生儿溶血病的标准方法。对 RhD 阴性孕妇的母体外周血浆进行胎儿 RhD 血型（RhD）基因分型，可仅针对 RhD 阳性妊娠进行 IgG 抗-D 靶向预防。我们建立了一种可靠的产前 RHD 基因分型方案。
对 153 例高加索 RhD 阴性孕妇在妊娠 27 周（7-38 周）进行检测，其中 18 例发生 RhD 同种免疫。基于自动化 DNA 提取和实时聚合酶链反应方法确定胎儿 RHD 基因型。靶向 RHD 基因的内含子 4 和外显子 5、7 和 10 以及 SRY 基因。
在所有 153 例妊娠中，胎儿 RhD 状态和性别均 100%正确预测（55 例 RhD 阳性男性，45 例 RhD 阳性女性；23 例 RhD 阴性男性，30 例 RhD 阴性女性）。
我们的非侵入性胎儿 RhD 测定方案的准确性和适用性可正确管理 RhD 不相容性妊娠。我们的方案可避免 153 例中的 53 例不必要的免疫预防。因此，我们建议将非侵入性胎儿 RHD 基因分型作为产前筛查的强制性部分引入。
