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Previous Volume 329:607-610 August 26, 1993 Number 9 Next

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ABSTRACT

Background An RhD-negative woman whose partner is heterozygous may have preexisting anti-RhD antibodies that may or may not affect a subsequent fetus, depending on whether it is heterozygous. A safe method of determining fetal RhD type early in pregnancy would eliminate the risks to an RhD-negative fetus of fetal-blood sampling or serial amniocenteses.

Methods We determined the RhD type in 15 fetuses using the polymerase chain reaction in amniotic cells and serologic methods in fetal blood collected simultaneously. In another 15 fetuses, the RhD type determined from chorionic-villus samples was compared with that identified by typing of DNA from the fetus itself.

Results RhD typing of DNA from amniotic cells correctly indicated the serologic type in every fetus. Of 10 fetuses with RhD-negative mothers, 4 were identified as RhD-negative and 6 as RhD-positive. Of five fetuses with RhD-positive mothers, four were identified as RhD-positive and one as RhD-negative. There was also complete agreement between the results of RhD typing of DNA from chorionic-villus samples and the results of typing of DNA from fetal tissue. Eleven fetuses were RhD-positive, and four were RhD-negative. Four RhD-positive fetuses had RhD-negative mothers. Three RhD-negative fetuses had RhD-positive mothers. There was no contamination by maternal RhD-positive DNA of the samples from RhD-negative fetuses.

Conclusions Determining fetal RhD type in amniotic cells without invading the fetomaternal circulation is a reliable method that will be valuable in the management of Rh alloimmunization.

Source Information

From the Royal Postgraduate Medical School, Institute of Obstetrics and Gynaecology, Queen Charlotte's and Chelsea Hospital, London (P.R.B., R.M.W., N.M.F.); and INSERM Unite 76, Institut National de Transfusion Sanguine, Paris (C.L.V.K., Y.C., B.C.-Z., J.-P.C.).

Address reprint requests to Dr. Bennett at the Royal Postgraduate Medical School, Institute of Obstetrics and Gynaecology, Queen Charlotte's and Chelsea Hospital, London W6 OXG, U.K.

Full Text of this Article

Related Letters:

Prenatal Determination of Fetal RhD Type
Simsek S., Bleeker P. M.M., von dem Borne A. E.G. Kr., Bennett P., Warwick R.
Extract | Full Text  
N Engl J Med 1994; 330:795-796, Mar 17, 1994. Correspondence

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