Document Detail


Routine fetal RHD genotyping with maternal plasma: a four-year experience in Belgium.
MedLine Citation:
PMID:  18039319     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The objective was to evaluate the diagnostic value of RHD fetal genotyping from the plasma of D- mothers as soon as 10 weeks' gestation in a routine clinical practice in Belgium. STUDY DESIGN AND METHODS: A prospective study was conducted between November 2002 and December 2006. DNA extraction was performed in an automated closed tube system. Fetal RHD/SRY genotypes were detected in the plasma of 563 pregnant mothers by real-time polymerase chain reaction (PCR) targeting multiple exons 4, 5, and 10 of the RHD gene and targeting an SRY gene sequence. These were compared to the D phenotypes determined in the 581 babies they delivered. RESULTS: By combining amplification of three exons, the concordance rate of fetal RHD genotypes in maternal plasma and newborn D phenotypes at delivery was 100 percent (99.8% including one unusual false-positive). The presence of nonfunctional RHD genes and the absence of a universal fetal marker, irrespective of fetal sex, did not influence the accuracy of fetal RhD status prediction. The RHD genotyping from 18 twin pregnancies was also assessed. Five weak D women were excluded from the RHD fetal genotyping prediction. Three discrepant results (0.5%) between predicted fetal genotype and cord blood phenotype were not confirmed by the baby phenotypes from venipuncture blood. CONCLUSION: Prenatal prediction of fetal RHD by targeting multiple exons from the maternal plasma with real-time PCR is highly sensitive and accurate. Over 4 years, this experience has highly modified our management of D- pregnant women.
Authors:
Jean-Marc Minon; Christiane Gerard; Jean-Marc Senterre; Jean-Pierre Schaaps; Jean-Michel Foidart
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Publication Detail:
Type:  Journal Article     Date:  2007-11-26
Journal Detail:
Title:  Transfusion     Volume:  48     ISSN:  0041-1132     ISO Abbreviation:  Transfusion     Publication Date:  2008 Feb 
Date Detail:
Created Date:  2008-01-30     Completed Date:  2008-03-28     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0417360     Medline TA:  Transfusion     Country:  United States    
Other Details:
Languages:  eng     Pagination:  373-81     Citation Subset:  IM    
Affiliation:
Department of Laboratory Medicine, the University Department of Fetal Medicine, Centre Hospitalier Régional de la Citadelle, Liège, Belgium. jean.marc.minon@chrcitadelle.be
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MeSH Terms
Descriptor/Qualifier:
Algorithms
Belgium
DNA / genetics
Exons / genetics
Female
Genotype
Humans
Infant, Newborn
Male
Mothers*
Phenotype
Plasma / metabolism*
Pregnancy
Rh-Hr Blood-Group System / blood*,  genetics*
Time Factors
Chemical
Reg. No./Substance:
0/Rh-Hr Blood-Group System; 9007-49-2/DNA

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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