Talk:Non-Invasive Prenatal Testing: Difference between revisions
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circulating cell-free fetal DNA | circulating cell-free fetal DNA | ||
==2014== | |||
===Diagnostic accuracy of routine antenatal determination of fetal RHD status across gestation: population based cohort study=== | |||
BMJ. 2014 Sep 4;349:g5243. doi: 10.1136/bmj.g5243. | |||
Chitty LS1, Finning K2, Wade A3, Soothill P4, Martin B5, Oxenford K6, Daniels G2, Massey E2. | |||
Abstract | |||
OBJECTIVES: | |||
To assess the accuracy of fetal RHD genotyping using cell-free fetal DNA in maternal plasma at different gestational ages. | |||
DESIGN: | |||
A prospective multicentre cohort study. | |||
SETTING: | |||
Seven maternity units in England. | |||
PARTICIPANTS: | |||
RhD negative pregnant women who booked for antenatal care before 24 weeks' gestation. | |||
INTERVENTIONS: | |||
Women who gave consent for fetal RHD genotyping had blood taken at the time of booking for antenatal care and, when possible, at other routine visits such as for Down's syndrome screening between 11 and 21 weeks' gestation, at the anomaly scan at 18-21 weeks, and in the third trimester when blood was taken for the routine antibody check. The results of cord blood analysis, done routinely in RhD negative pregnancies, were also obtained to confirm the fetal RHD genotyping. | |||
MAIN OUTCOME MEASURES: | |||
The accuracy of fetal RHD genotyping compared with RhD status predicted by cord blood serology. | |||
RESULTS: | |||
Up to four analyses per woman were performed in 2288 women, generating 4913 assessable fetal results. Sensitivity for detection of fetal RHD positivity was 96.85% (94.95% to 98.05%), 99.83% (99.06% to 99.97%), 99.67% (98.17% to 99.94%), 99.82% (98.96% to 99.97%), and 100% (99.59% to 100%) at <11, 11-13, 14-17, 18-23, and >23 completed weeks' gestation, respectively. Before 11 weeks' gestation 16/865 (1.85%) babies tested were falsely predicted as RHD negative. | |||
CONCLUSIONS: | |||
Mass throughput fetal RHD genotyping is sufficiently accurate for the prediction of RhD type if it is performed from 11 weeks' gestation. Testing before this time could result in a small but significant number of babies being incorrectly classified as RHD negative. These mothers would not receive anti-RhD immunoglobulin, and there would be a risk of haemolytic disease of the newborn in subsequent pregnancies. | |||
© Chitty et al 2014. | |||
PMID 25190055 | |||
http://www.bmj.com/content/349/bmj.g5243 | |||
Revision as of 14:35, 24 September 2014
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Cite this page: Hill, M.A. (2026, March 21) Embryology Non-Invasive Prenatal Testing. Retrieved from https://embryology.med.unsw.edu.au/embryology/index.php/Talk:Non-Invasive_Prenatal_Testing |
circulating cell-free fetal DNA
2014
Diagnostic accuracy of routine antenatal determination of fetal RHD status across gestation: population based cohort study
BMJ. 2014 Sep 4;349:g5243. doi: 10.1136/bmj.g5243.
Chitty LS1, Finning K2, Wade A3, Soothill P4, Martin B5, Oxenford K6, Daniels G2, Massey E2.
Abstract
OBJECTIVES: To assess the accuracy of fetal RHD genotyping using cell-free fetal DNA in maternal plasma at different gestational ages. DESIGN: A prospective multicentre cohort study. SETTING: Seven maternity units in England. PARTICIPANTS: RhD negative pregnant women who booked for antenatal care before 24 weeks' gestation. INTERVENTIONS: Women who gave consent for fetal RHD genotyping had blood taken at the time of booking for antenatal care and, when possible, at other routine visits such as for Down's syndrome screening between 11 and 21 weeks' gestation, at the anomaly scan at 18-21 weeks, and in the third trimester when blood was taken for the routine antibody check. The results of cord blood analysis, done routinely in RhD negative pregnancies, were also obtained to confirm the fetal RHD genotyping. MAIN OUTCOME MEASURES: The accuracy of fetal RHD genotyping compared with RhD status predicted by cord blood serology. RESULTS: Up to four analyses per woman were performed in 2288 women, generating 4913 assessable fetal results. Sensitivity for detection of fetal RHD positivity was 96.85% (94.95% to 98.05%), 99.83% (99.06% to 99.97%), 99.67% (98.17% to 99.94%), 99.82% (98.96% to 99.97%), and 100% (99.59% to 100%) at <11, 11-13, 14-17, 18-23, and >23 completed weeks' gestation, respectively. Before 11 weeks' gestation 16/865 (1.85%) babies tested were falsely predicted as RHD negative. CONCLUSIONS: Mass throughput fetal RHD genotyping is sufficiently accurate for the prediction of RhD type if it is performed from 11 weeks' gestation. Testing before this time could result in a small but significant number of babies being incorrectly classified as RHD negative. These mothers would not receive anti-RhD immunoglobulin, and there would be a risk of haemolytic disease of the newborn in subsequent pregnancies. © Chitty et al 2014.
PMID 25190055
