Utilisation en routine clinique du genotypage foetal RHD sur plasma maternel: bilan de deux ans d'activite

• Main Authors: Minon, Jean-Marc, Schaaps, Jean-Pierre, Retz, Maria Christina, Dricot, Jean-François, Foidart, Jean-Michel, Senterre, Jean-Marc
• Format: Web Resource
• Language: French
• Published: Masson et Cie 01.09.2005
• Subjects: Human health sciences; Médecine de la reproduction (Gynécologie, andrologie, obstétrique); Reproductive medicine (gynecology, andrology, obstetrics); Sciences de la santé humaine
• ISSN: 1773-0430; 0368-2315
• DOI: 10.1016/s0368-2315(05)82852-2

OBJECTIVES: To evaluate the predictive value of RHD fetal genotype in maternal plasma of Rh D negative mothers after 10 weeks of gestation in a clinical use. MATERIAL AND METHOD: Prospective, comparative study between fetal RHD genotyping in maternal plasma, with amplification of exons 4,5,10 of the RHD gene, by real-time multiplex PCR, and Rh D serology at birth, in 218 pregnancy and their 223 babies, between November 2002 and 2004. RESULTS: Combining the amplification of three exons, the concordance rate of fetal Rh D genotyping in maternal plasma and baby phenotyping at delivery was 100%. Four women whose the babies were Rh D negative were positive for RHD exon 10 during pregnancy. This positivity was, in three cases, correlated with the presence of RHDpsi pseudogene and in last case, with a haplotype Cdes (r's). RHD genotyping was performed for five twin pregnancies. CONCLUSION: Multiplex PCR using maternal plasma provides perfect prenatal prediction of fetal RHD gene. These results confirm that this non invasive procedure is the preferred method for assessing Rh D fetal status in Rh negative mothers. Using this method for two years in routine practice has led us to modify our management scheme for sensitized Rh D-negative pregnant women.