BMJ  2008;336:906 (26 April), doi:10.1136/bmj.39556.499549.80

Letters

Fetal RHD typing

Is fetal RHD typing in all RhD negative women cost effective?

The first 150 words of the full text of this article appear below.

Finning et al show that non-invasive detection of fetal RHD status can be performed in a high throughput laboratory with high sensitivity.¹ The associated editorial suggests that universal fetal genotyping of all RhD negative women is a logical extension that would allow the targeting of antenatal anti-D prophylaxis. But would mass testing be cost effective and, if so, under what conditions? The original National Institute for Health and Clinical Excellence guidance on routine antenatal anti-D prophylaxis in the UK was based on a detailed economic analysis.^{2 3} This guidance is currently being reviewed, but the introduction of non-invasive prenatal diagnosis is not being dealt with.

We represent the socioeconomic group of the SAFE Network of Excellence funded by the European Commission to inform the implementation of non-invasive prenatal diagnosis tests.⁴ We have been investigating fetal RHD genotyping using international data on the diagnostic accuracy of non-invasive prenatal tests.⁵ Unlike previous developments . . . [Full text of this article]

¹ Clinical Sciences Institute, Warwick Medical School, University of Warwick, ² Institute for Health Management and Policy, Department of Prenatal and Reproductive Care, Erasmus Medical Centre, Rotterdam University, Netherlands, ³ Institute for Epidemiology, Social Medicine and Health System Research, Hanover Medical School, Germany, ⁴ Department of Transfusion Medicine, Georg-August-University, Göttingen, Germany

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Relevant Article

Effect of high throughput RHD typing of fetal DNA in maternal plasma on use of anti-RhD immunoglobulin in RhD negative pregnant women: prospective feasibility study

Kirstin Finning, Pete Martin, Joanna Summers, Edwin Massey, Geoff Poole, and Geoff Daniels
BMJ 2008 336: 816-818. [Abstract] [Full Text] [PDF]