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非侵入性产前 FetoGnost RhD 检测在预测胎儿 RhD 血型状态方面的诊断性能。

Diagnostic performance of the noninvasive prenatal FetoGnost RhD assay for the prediction of the fetal RhD blood group status.

机构信息

Department of Transfusion Medicine, University Medical Center Göttingen, Robert-Koch-Str. 40, 37075, Göttingen, Germany.

Ingenetix GmbH, Vienna, Austria.

出版信息

Arch Gynecol Obstet. 2021 Nov;304(5):1191-1196. doi: 10.1007/s00404-021-06055-1. Epub 2021 Apr 9.

Abstract

PURPOSE

To evaluate the diagnostic accuracy of a commercially available test kit for noninvasive prenatal determination of the fetal RhD status (NIPT-RhD) with a focus on early gestation and multiple pregnancies.

METHODS

The FetoGnost RhD assay (Ingenetix, Vienna, Austria) is routinely applied for clinical decision making either in woman with anti-D alloimmunization or to target the application of routine antenatal anti-D prophylaxis (RAADP) to women with a RhD positive fetus. Based on existing data in the laboratory information system the newborn's serological RhD status was compared with NIPT RhD results.

RESULTS

Since 2009 NIPT RhD was performed in 2968 pregnant women between weeks 5 + 6 and 40 + 0 of gestation (median 12 + 6) and conclusive results were obtained in 2888 (97.30%) cases. Diagnostic accuracy was calculated from those 2244 (77.70%) cases with the newborn's serological RhD status reported. The sensitivity of the FetoGnost RhD assay was 99.93% (95% CI 99.61-99.99%) and the specificity was 99.61% (95% CI 98.86-99.87%). No false-positive or false-negative NIPT RhD result was observed in 203 multiple pregnancies.

CONCLUSION

NIPT RhD results are reliable when obtained with FetoGnost RhD assay. Targeted routine anti-D-prophylaxis can start as early as 11 + 0 weeks of gestation in singleton and multiple pregnancies.

摘要

目的

评估一种商业化的非侵入性产前胎儿 RhD 状态检测试剂盒(NIPT-RhD)的诊断准确性,重点关注早孕期和多胎妊娠。

方法

FetoGnost RhD 检测试剂盒(Ingenetix,维也纳,奥地利)常规应用于临床决策,无论是在抗-D 同种免疫的妇女中,还是针对具有 RhD 阳性胎儿的妇女应用常规产前抗-D 预防(RAADP)。基于实验室信息系统中的现有数据,将新生儿的血清学 RhD 状态与 NIPT RhD 结果进行比较。

结果

自 2009 年以来,在 5+6 周至 40+0 孕周(中位数 12+6)的 2968 名孕妇中进行了 NIPT RhD,在 2888 名(97.30%)孕妇中获得了明确的结果。从报告新生儿血清学 RhD 状态的 2244 例(77.70%)病例中计算了诊断准确性。FetoGnost RhD 检测试剂盒的灵敏度为 99.93%(95%可信区间 99.61-99.99%),特异性为 99.61%(95%可信区间 98.86-99.87%)。在 203 例多胎妊娠中未观察到假阳性或假阴性的 NIPT RhD 结果。

结论

使用 FetoGnost RhD 检测试剂盒获得的 NIPT RhD 结果可靠。在单胎和多胎妊娠中,可早在 11+0 孕周开始进行有针对性的常规抗-D 预防。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a466/8490250/3415f886f4d9/404_2021_6055_Fig1_HTML.jpg

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