Skip Navigation LinksHome > October 2005 - Volume 106 - Issue 4 > Noninvasive Prenatal Diagnosis of Fetal Rhesus D: Ready for...
Obstetrics & Gynecology:
doi: 10.1097/01.AOG.0000179477.59385.93
Current Commentary

Noninvasive Prenatal Diagnosis of Fetal Rhesus D: Ready for Prime(r) Time

Bianchi, Diana W. MD1; Avent, Neil D. PhD2; Costa, Jean-Marc PhD3; van der Schoot, C Ellen MD, PhD4

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Abstract

Rhesus (Rh) D blood group incompatibility between the pregnant woman and her fetus is a significant problem due to the possibility of maternal alloimmunization and consequent hemolytic disease of the newborn. The RhD-negative blood group is found in 15% of whites, 3–5% of black Africans, and is rare in Asians. Advances in both our understanding of the RHD locus and its variants, as well as technical improvements in the extraction and amplification of cell-free fetal DNA in maternal plasma, have led to incorporation of noninvasive diagnosis of RHD genotype into routine prenatal care in the United Kingdom, France, and the Netherlands. In this commentary we examine the experience to date with large-scale clinical trials performed in the European Union, describe approaches to reduce false-positive and false-negative results, and review ongoing research to standardize assays and reduce costs using automated assays. False-negative cases are mainly due to either a lack of fetal DNA in the maternal sample due to early gestation or insensitive methods. False-positive cases are due to genotypic variants observed in individuals of African ancestry. Noninvasive prenatal diagnosis of fetal Rhesus D genotype is sensitive and accurate and has been widely validated in Europe. The United States should begin to undertake clinical trials to bring this technology to patient care as soon as possible.

© 2005 by The American College of Obstetricians and Gynecologists.

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