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Evaluation of non‐invasive prenatal RHD genotyping of the fetus
Author(s) -
Hyland Catherine A,
Gardener Glenn J,
Davies Helen,
Ahvenainen Minna,
Flower Robert L,
Irwin Darryl,
Morris Jonathan M,
Ward Christopher M,
Hyett Jonathan A
Publication year - 2009
Publication title -
medical journal of australia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.904
H-Index - 131
eISSN - 1326-5377
pISSN - 0025-729X
DOI - 10.5694/j.1326-5377.2009.tb02668.x
Subject(s) - cell free fetal dna , fetus , testis determining factor , genotyping , medicine , amniocentesis , obstetrics , prenatal diagnosis , pregnancy , venous blood , prospective cohort study , genotype , biology , genetics , gene , y chromosome
Objective: To evaluate a non‐invasive molecular test using free circulating fetal DNA in maternal plasma to predict the fetal RHD type. Design: A prospective cohort study. Participants and setting: Venous blood samples were collected from 140 Rhesus (Rh) D‐negative women booked for antenatal care in two tertiary maternity hospitals in Sydney and Brisbane between November 2006 and April 2008. Cell‐free DNA, including free maternal and fetal DNA, was extracted from maternal plasma in the tertiary Australian Red Cross Blood Service laboratory, and three exon regions of the RHD gene were amplified. Main outcome measures: Comparison of the predicted fetal RHD status and the infant's RhD serotype. Secondary analysis involved using SRY and RASSF1A assays as internal controls to confirm the presence of fetal DNA in RHD ‐negative samples. Results: Of 140 samples tested, results for RHD status were assigned for 135, and all 135 predictions were correct. A result was not assigned in five cases: three did not meet strict threshold criteria for classification, and two were due to RHD variants. Fetal SRY status was correctly predicted in 137 of 140 cases. In 16 samples typed both RHD ‐ and SRY ‐negative, a positive RASSF1A result verified the presence of fetal DNA. Conclusions: Non‐invasive testing of multiple exons provides a robust method of assessing fetal RHD status, and provides a safer alternative to amniocentesis for the management of RhD‐negative pregnant women who are isoimmunised.