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Determination of fetal RhD status by Free DNAFrom: jafar6 (jafar6@optonline.net)Tue Oct 8 21:46:04 2002
I have a multiparous patient who is Rh sensitized (anti-D). With her last (2nd) pregnancy, her anti-D titer rose from 1/16 to 1/128 at about 24 weeks. Rh genotyping by amniocentesis showed the fetus to be Rh negative. Although middle cerebral artery Dopplers suggested that the fetus was not anemic, the rising anti-D titers led us to perform the amniocentesis. The baby was fine. She delivered an unaffected Rh positive fetus in her first pregnancy (with a different father). An amniocentesis was also done during that pregnancy for delta OD 450, at about 36 weeks. This pregnancy is with the same father as the last pregnancy. He is Rh+ (and probably heterozygous for RhD, assuming paternity). This time, we would like to avoid amniocentesis, if possible. Articles have suggested that sampling maternal blood for free fetal DNA is sensitive and specific for the fetal RhD gene and therefore the fetal Rh phenotype. Has anyone here used this technique? Does anyone know of a clinical or research lab that could do it? Thanks in advance, Gary Kleinman, M.D. Pisces
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