Re: Determination of fetal RhD status by Free DNA

From: zygote@icsi.net
Wed Oct 9 15:25:54 2002


AS someone who has used MCA-PSV for almost 10 years if the MCA is nbormal then amnio is not indicated. There is no utility to repeat titers once the critical titer has been passed. It is not valid for assessing risk for fetal anemia.

On 8 Oct 2002 at 21:48, jafar6 wrote:

> 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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