Diagnostic accuracy of routine antenatal determination of fetal RHD status across gestation: population based cohort study
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...
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| Veröffentlicht in: | BMJ (Online) 2014-09, Vol.349 (7975), p.g5243-g5243 |
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| creator | Chitty, Lyn S Finning, Kirstin Wade, Angela Soothill, Peter Martin, Bill Oxenford, Kerry Daniels, Geoff Massey, Edwin |
| description | 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 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. |
| doi_str_mv | 10.1136/bmj.g5243 |
| format | Article |
| fullrecord | <record><control><sourceid>jstor_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_4154470</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><jstor_id>26517004</jstor_id><sourcerecordid>26517004</sourcerecordid><originalsourceid>FETCH-LOGICAL-b515t-d42be76206c8106a14c1983bf0c5e99c0b067e2105eb3f27b08746aff37db7e33</originalsourceid><addsrcrecordid>eNqFkk1v1DAQhi1ERVelB34AKBIc4JDiiT_DAQm1lFaqhITgbNmOs80qiRfbQVp-Pc6mtBSp4Is1nmfe0YxfhJ4BPgEg_K0ZNidrVlHyCK1AMF6CJOQxWuGa1aUEIg_RcYwbjHFFhKw5e4IOKwY1xoyt0M-zTq9HH1NnC23tFLTdFb4tgp9SN7pCj8mNOum-aFxyYehy0PlxRlo3P3-5OCti0mmKuT74GIu1m-MMvSu2fjv1S4HR0TWF9dc-pFwwNbun6KDVfXTHN_cR-nb-8evpRXn1-dPl6Yer0jBgqWxoZZzgFeZWAuYaqIVaEtNiy1xdW2wwF64CzJwhbSUMloJy3bZENEY4Qo7Q-0V3O5nBNdaNKehebUM36LBTXnfqfmbsrtXa_1AUGKUCZ4HXNwLBf5_ydGroonV9r0fnp6iAEyookRX5P8o4ZpKIverLv9CNn8KYN6FA5CMFqfk_KQ4CaqgozdSbhdr_QHDt7XSA1ewSlV2i9i7J7Is_13FL_vZEBp4vwCYmH-7ynIHAeG72asnPmg_3-QVfgs5J</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1777787396</pqid></control><display><type>article</type><title>Diagnostic accuracy of routine antenatal determination of fetal RHD status across gestation: population based cohort study</title><source>Applied Social Sciences Index & Abstracts (ASSIA)</source><source>Jstor Complete Legacy</source><source>MEDLINE</source><source>BMJ Journals - NESLi2</source><creator>Chitty, Lyn S ; Finning, Kirstin ; Wade, Angela ; Soothill, Peter ; Martin, Bill ; Oxenford, Kerry ; Daniels, Geoff ; Massey, Edwin</creator><creatorcontrib>Chitty, Lyn S ; Finning, Kirstin ; Wade, Angela ; Soothill, Peter ; Martin, Bill ; Oxenford, Kerry ; Daniels, Geoff ; Massey, Edwin</creatorcontrib><description>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.</description><edition>International edition</edition><identifier>ISSN: 0959-8138</identifier><identifier>ISSN: 1756-1833</identifier><identifier>ISSN: 0959-8146</identifier><identifier>EISSN: 1756-1833</identifier><identifier>DOI: 10.1136/bmj.g5243</identifier><identifier>PMID: 25190055</identifier><identifier>CODEN: BMJOAE</identifier><language>eng</language><publisher>England: British Medical Journal Publishing Group</publisher><subject>Accuracy ; Antigens ; Babies ; Blood groups ; Clinical medicine ; Consent ; Diagnostic tests ; Disease prevention ; DNA - analysis ; DNA - blood ; Erythroblastosis, Fetal - diagnosis ; Erythroblastosis, Fetal - genetics ; Erythroblastosis, Fetal - immunology ; False Negative Reactions ; False Positive Reactions ; Female ; Fetal Blood - immunology ; Fetuses ; Genotype ; Genotype & phenotype ; Gestational Age ; Humans ; Immunoglobulins ; Laboratories ; Midwifery ; Plasma ; Pregnancy ; Pregnancy Trimesters ; Prenatal care ; Prenatal Diagnosis ; Prospective Studies ; Rh-Hr Blood-Group System - genetics ; Sensitivity and Specificity ; Serology ; Womens health</subject><ispartof>BMJ (Online), 2014-09, Vol.349 (7975), p.g5243-g5243</ispartof><rights>Chitty et al 2014</rights><rights>Chitty et al 2014.</rights><rights>Copyright BMJ Publishing Group Sep 20, 2014</rights><rights>Copyright BMJ Publishing Group LTD Sep 4, 2014</rights><rights>Chitty et al 2014 2014 Chitty et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-b515t-d42be76206c8106a14c1983bf0c5e99c0b067e2105eb3f27b08746aff37db7e33</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttp://bmj.com/content/349/bmj.g5243.full.pdf$$EPDF$$P50$$Gbmj$$Hfree_for_read</linktopdf><linktohtml>$$Uhttp://bmj.com/content/349/bmj.g5243.full$$EHTML$$P50$$Gbmj$$Hfree_for_read</linktohtml><link.rule.ids>114,115,230,314,776,780,799,881,3183,23550,27901,27902,30976,57992,58225,77569,77600</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25190055$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Chitty, Lyn S</creatorcontrib><creatorcontrib>Finning, Kirstin</creatorcontrib><creatorcontrib>Wade, Angela</creatorcontrib><creatorcontrib>Soothill, Peter</creatorcontrib><creatorcontrib>Martin, Bill</creatorcontrib><creatorcontrib>Oxenford, Kerry</creatorcontrib><creatorcontrib>Daniels, Geoff</creatorcontrib><creatorcontrib>Massey, Edwin</creatorcontrib><title>Diagnostic accuracy of routine antenatal determination of fetal RHD status across gestation: population based cohort study</title><title>BMJ (Online)</title><addtitle>BMJ</addtitle><description>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.</description><subject>Accuracy</subject><subject>Antigens</subject><subject>Babies</subject><subject>Blood groups</subject><subject>Clinical medicine</subject><subject>Consent</subject><subject>Diagnostic tests</subject><subject>Disease prevention</subject><subject>DNA - analysis</subject><subject>DNA - blood</subject><subject>Erythroblastosis, Fetal - diagnosis</subject><subject>Erythroblastosis, Fetal - genetics</subject><subject>Erythroblastosis, Fetal - immunology</subject><subject>False Negative Reactions</subject><subject>False Positive Reactions</subject><subject>Female</subject><subject>Fetal Blood - immunology</subject><subject>Fetuses</subject><subject>Genotype</subject><subject>Genotype & phenotype</subject><subject>Gestational Age</subject><subject>Humans</subject><subject>Immunoglobulins</subject><subject>Laboratories</subject><subject>Midwifery</subject><subject>Plasma</subject><subject>Pregnancy</subject><subject>Pregnancy Trimesters</subject><subject>Prenatal care</subject><subject>Prenatal Diagnosis</subject><subject>Prospective Studies</subject><subject>Rh-Hr Blood-Group System - genetics</subject><subject>Sensitivity and Specificity</subject><subject>Serology</subject><subject>Womens health</subject><issn>0959-8138</issn><issn>1756-1833</issn><issn>0959-8146</issn><issn>1756-1833</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2014</creationdate><recordtype>article</recordtype><sourceid>9YT</sourceid><sourceid>ACMMV</sourceid><sourceid>EIF</sourceid><sourceid>7QJ</sourceid><sourceid>8G5</sourceid><sourceid>BENPR</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNqFkk1v1DAQhi1ERVelB34AKBIc4JDiiT_DAQm1lFaqhITgbNmOs80qiRfbQVp-Pc6mtBSp4Is1nmfe0YxfhJ4BPgEg_K0ZNidrVlHyCK1AMF6CJOQxWuGa1aUEIg_RcYwbjHFFhKw5e4IOKwY1xoyt0M-zTq9HH1NnC23tFLTdFb4tgp9SN7pCj8mNOum-aFxyYehy0PlxRlo3P3-5OCti0mmKuT74GIu1m-MMvSu2fjv1S4HR0TWF9dc-pFwwNbun6KDVfXTHN_cR-nb-8evpRXn1-dPl6Yer0jBgqWxoZZzgFeZWAuYaqIVaEtNiy1xdW2wwF64CzJwhbSUMloJy3bZENEY4Qo7Q-0V3O5nBNdaNKehebUM36LBTXnfqfmbsrtXa_1AUGKUCZ4HXNwLBf5_ydGroonV9r0fnp6iAEyookRX5P8o4ZpKIverLv9CNn8KYN6FA5CMFqfk_KQ4CaqgozdSbhdr_QHDt7XSA1ewSlV2i9i7J7Is_13FL_vZEBp4vwCYmH-7ynIHAeG72asnPmg_3-QVfgs5J</recordid><startdate>20140904</startdate><enddate>20140904</enddate><creator>Chitty, Lyn S</creator><creator>Finning, Kirstin</creator><creator>Wade, Angela</creator><creator>Soothill, Peter</creator><creator>Martin, Bill</creator><creator>Oxenford, Kerry</creator><creator>Daniels, Geoff</creator><creator>Massey, Edwin</creator><general>British Medical Journal Publishing Group</general><general>BMJ Publishing Group</general><general>BMJ Publishing Group LTD</general><general>BMJ Publishing Group Ltd</general><scope>9YT</scope><scope>ACMMV</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QJ</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88I</scope><scope>8AF</scope><scope>8FE</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>ASE</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BHPHI</scope><scope>BTHHO</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FPQ</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>HCIFZ</scope><scope>K6X</scope><scope>K9.</scope><scope>KB0</scope><scope>LK8</scope><scope>M2O</scope><scope>M2P</scope><scope>M7P</scope><scope>MBDVC</scope><scope>NAPCQ</scope><scope>PHGZM</scope><scope>PHGZT</scope><scope>PJZUB</scope><scope>PKEHL</scope><scope>PPXIY</scope><scope>PQEST</scope><scope>PQGLB</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>Q9U</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20140904</creationdate><title>Diagnostic accuracy of routine antenatal determination of fetal RHD status across gestation: population based cohort study</title><author>Chitty, Lyn S ; Finning, Kirstin ; Wade, Angela ; Soothill, Peter ; Martin, Bill ; Oxenford, Kerry ; Daniels, Geoff ; Massey, Edwin</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-b515t-d42be76206c8106a14c1983bf0c5e99c0b067e2105eb3f27b08746aff37db7e33</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2014</creationdate><topic>Accuracy</topic><topic>Antigens</topic><topic>Babies</topic><topic>Blood groups</topic><topic>Clinical medicine</topic><topic>Consent</topic><topic>Diagnostic tests</topic><topic>Disease prevention</topic><topic>DNA - analysis</topic><topic>DNA - blood</topic><topic>Erythroblastosis, Fetal - diagnosis</topic><topic>Erythroblastosis, Fetal - genetics</topic><topic>Erythroblastosis, Fetal - immunology</topic><topic>False Negative Reactions</topic><topic>False Positive Reactions</topic><topic>Female</topic><topic>Fetal Blood - immunology</topic><topic>Fetuses</topic><topic>Genotype</topic><topic>Genotype & phenotype</topic><topic>Gestational Age</topic><topic>Humans</topic><topic>Immunoglobulins</topic><topic>Laboratories</topic><topic>Midwifery</topic><topic>Plasma</topic><topic>Pregnancy</topic><topic>Pregnancy Trimesters</topic><topic>Prenatal care</topic><topic>Prenatal Diagnosis</topic><topic>Prospective Studies</topic><topic>Rh-Hr Blood-Group System - genetics</topic><topic>Sensitivity and Specificity</topic><topic>Serology</topic><topic>Womens health</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Chitty, Lyn S</creatorcontrib><creatorcontrib>Finning, Kirstin</creatorcontrib><creatorcontrib>Wade, Angela</creatorcontrib><creatorcontrib>Soothill, Peter</creatorcontrib><creatorcontrib>Martin, Bill</creatorcontrib><creatorcontrib>Oxenford, Kerry</creatorcontrib><creatorcontrib>Daniels, Geoff</creatorcontrib><creatorcontrib>Massey, Edwin</creatorcontrib><collection>BMJ Open Access Journals</collection><collection>BMJ Journals:Open Access</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Applied Social Sciences Index & Abstracts (ASSIA)</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Science Database (Alumni Edition)</collection><collection>STEM Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>British Nursing Index</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Natural Science Collection</collection><collection>BMJ Journals</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>British Nursing Index (BNI) (1985 to Present)</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>SciTech Premium Collection</collection><collection>British Nursing Index</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>ProQuest Biological Science Collection</collection><collection>Research Library</collection><collection>Science Database</collection><collection>Biological Science Database</collection><collection>Research Library (Corporate)</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest Central (New)</collection><collection>ProQuest One Academic (New)</collection><collection>ProQuest Health & Medical Research Collection</collection><collection>ProQuest One Academic Middle East (New)</collection><collection>ProQuest One Health & Nursing</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Applied & Life Sciences</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>BMJ (Online)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Chitty, Lyn S</au><au>Finning, Kirstin</au><au>Wade, Angela</au><au>Soothill, Peter</au><au>Martin, Bill</au><au>Oxenford, Kerry</au><au>Daniels, Geoff</au><au>Massey, Edwin</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Diagnostic accuracy of routine antenatal determination of fetal RHD status across gestation: population based cohort study</atitle><jtitle>BMJ (Online)</jtitle><addtitle>BMJ</addtitle><date>2014-09-04</date><risdate>2014</risdate><volume>349</volume><issue>7975</issue><spage>g5243</spage><epage>g5243</epage><pages>g5243-g5243</pages><issn>0959-8138</issn><issn>1756-1833</issn><issn>0959-8146</issn><eissn>1756-1833</eissn><coden>BMJOAE</coden><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.</abstract><cop>England</cop><pub>British Medical Journal Publishing Group</pub><pmid>25190055</pmid><doi>10.1136/bmj.g5243</doi><edition>International edition</edition><oa>free_for_read</oa></addata></record> |
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| subjects | Accuracy Antigens Babies Blood groups Clinical medicine Consent Diagnostic tests Disease prevention DNA - analysis DNA - blood Erythroblastosis, Fetal - diagnosis Erythroblastosis, Fetal - genetics Erythroblastosis, Fetal - immunology False Negative Reactions False Positive Reactions Female Fetal Blood - immunology Fetuses Genotype Genotype & phenotype Gestational Age Humans Immunoglobulins Laboratories Midwifery Plasma Pregnancy Pregnancy Trimesters Prenatal care Prenatal Diagnosis Prospective Studies Rh-Hr Blood-Group System - genetics Sensitivity and Specificity Serology Womens health |
| title | Diagnostic accuracy of routine antenatal determination of fetal RHD status across gestation: population based cohort study |
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