(Abstracted from BMJ 2016;355:i5789)
The risk of maternal alloimmunization due to RhD incompatibility has decreased with use of antenatal and postnatal anti–D immunoglobulin prophylaxis. The discovery of cell-free fetal (cff) DNA in maternal plasma during pregnancy and the feasibility of fetal RhD testing using this source of DNA make it possible to determine fetal RhD type and to restrict the use of antenatal anti–D immunoglobulin to only those RhD-negative women carrying an RhD-positive fetus.
Department of Experimental Immunohematology, Sanquin Research, and Landsteiner Laboratory, Academic Medical Center, University of Amsterdam, Amsterdam (M.H., F.F.T., B.V., A.A.S., C.E.S.); Center for Clinical Transfusion Research, Sanquin Research, and Department of Immunohematology and Blood Transfusion, Leiden University Medical Center, Leiden (M.H.); Department of Immunohematology Diagnostic Services, Sanquin Research, Amsterdam (M.H., B.V., H.W.); Division Woman and Baby, Department of Obstetrics, University Medical Center Utrecht, Utrecht (F.F.T., G.C.M.L.P.-C., P.G.S.); Department of Child Health, Netherlands Organization for Applied Scientific Research, Leiden (C.P.B.P.); Service for Vaccine Provision and Prevention Programs, National Institute for Public Health and the Environment (H.H.); and Center for Population Screening, National Institute for Public Health and the Environment, Bilthoven (F.A.), the Netherlands