Loading...
Please wait, while we are loading the content...
Similar Documents
Non-invasive prenatal testing for sub-saharan Africa: Tailoring approaches for foetal RHD genotyping in RHD-negative pregnant women to manage African-associated RHD Alleles
| Content Provider | Semantic Scholar |
|---|---|
| Author | McGowan, Eunike C. Flower, Robert L. P. O'Brien, Helen L. Millard, Glenda M. Hyland, Catherine A. |
| Copyright Year | 2017 |
| Abstract | BACKGROUND Non-invasive prenatal testing (NIPT) for cell-free foetal (cff) RHD genotyping has clinical value to guide pregnancy management for alloimmunised RhD-negative pregnant women and guide antenatal anti-D prophylaxis needs for all D-negative women to prevent alloimmunisation. This assay assumes there is a maternal RHD gene deletion and genotyping is challenged where the mother carries RHD alleles such as RHD*Ψ and RHD-CE-Ds which are frequent in Sub-Saharan Africa. AIM AND OBJECTIVE This paper reviews the range of RHD alleles reported in sub-Saharan African populations and strategies in managing African-associated RHD alleles to ensure the accuracy of cffRHD genotyping. STUDY DESIGN/MATERIALS AND METHODS Online literature searches using Google, Google Scholar and PubMed, textbooks and International Society of Blood Transfusion Blood Group Tables. RESULTS A NIPT assay design for cffRHD, tailored with the SAFE recommended RHD exon 5 and 7 approach, can provide foetal D-positive or D-negative predictions when a maternal RHD*Ψ and RHD-CE-Ds is present. Inclusion of RHD exon 4 in NIPT is a tool for increasing confidence in D-phenotype prediction. CONCLUSIONS A strategic approach to NIPT cffRHD genotyping can overcome challenges with maternal RHD interference from RHD*Ψ and RHDCE- Ds alleles in D-negative pregnant women. Accommodating for these RHD alleles provides knowledge for clinical management to minimise maternal anti-D alloimmunisation and haemolytic disease of the foetus and newborn. Continuing study of RHD alleles, including those that are novel and low-frequency, is important in future approaches to NIPT cffRHD genotyping in sub- Saharan African populations. |
| Starting Page | 18 |
| Ending Page | 29 |
| Page Count | 12 |
| File Format | PDF HTM / HTML |
| Volume Number | 19 |
| Alternate Webpage(s) | https://www.ajol.info/index.php/asan/article/download/168100/157503 |
| Language | English |
| Access Restriction | Open |
| Content Type | Text |
| Resource Type | Article |
