Journalartikel

Targeted antenatal anti-D prophylaxis for RhD-negative pregnant women: a systematic review


AutorenlisteRunkel, Britta; Bein, Gregor; Sieben, Wiebke; Sow, Dorothea; Polus, Stephanie; Fleer, Daniel

Jahr der Veröffentlichung2020

ZeitschriftBMC Pregnancy and Childbirth

Bandnummer20

Heftnummer1

eISSN1471-2393

Open Access StatusGold

DOI Linkhttps://doi.org/10.1186/s12884-020-2742-4

VerlagBioMed Central


Abstract
BackgroundAll non-sensitized Rhesus D (RhD)-negative pregnant women in Germany receive antenatal anti-D prophylaxis without knowledge of fetal RhD status. Non-invasive prenatal testing (NIPT) of cell-free fetal DNA in maternal plasma could avoid unnecessary anti-D administration. In this paper, we systematically reviewed the evidence on the benefit of NIPT for fetal RhD status in RhD-negative pregnant women.MethodsWe systematically searched several bibliographic databases, trial registries, and other sources (up to October 2019) for controlled intervention studies investigating NIPT for fetal RhD versus conventional anti-D prophylaxis. The focus was on the impact on fetal and maternal morbidity. We primarily considered direct evidence (from randomized controlled trials) or if unavailable, linked evidence (from diagnostic accuracy studies and from controlled intervention studies investigating the administration or withholding of anti-D prophylaxis). The results of diagnostic accuracy studies were pooled in bivariate meta-analyses.ResultsNeither direct evidence nor sufficient data for linked evidence were identified. Meta-analysis of data from about 60,000 participants showed high sensitivity (99.9%; 95% CI [99.5%; 100%] and specificity (99.2%; 95% CI [98.5%; 99.5%]).ConclusionsNIPT for fetal RhD status is equivalent to conventional serologic testing using the newborn's blood. Studies investigating patient-relevant outcomes are still lacking.



Zitierstile

Harvard-ZitierstilRunkel, B., Bein, G., Sieben, W., Sow, D., Polus, S. and Fleer, D. (2020) Targeted antenatal anti-D prophylaxis for RhD-negative pregnant women: a systematic review, BMC Pregnancy and Childbirth, 20(1). https://doi.org/10.1186/s12884-020-2742-4

APA-ZitierstilRunkel, B., Bein, G., Sieben, W., Sow, D., Polus, S., & Fleer, D. (2020). Targeted antenatal anti-D prophylaxis for RhD-negative pregnant women: a systematic review. BMC Pregnancy and Childbirth. 20(1). https://doi.org/10.1186/s12884-020-2742-4



Schlagwörter


Benefit assessmentFETUSGenotyping techniquesMATERNAL PLASMANONINVASIVE FETAL RHDRh-Hr blood-group systemsystematic review


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