Management of RhD-negative Pregnancies: Do New Technologies Make a Difference?

摘要

In this work we are modelling the management process of RhD negative pregnancies. The current practice is based on the use of anti-D as a prophylactic measure to prevent sensitisations (development of antibodies by the mother against fetal blood type). RhD NIPD is a diagnostics test designed to improve management of RhD negative pregnancies and to make the usage of anti-D prophylaxis more efficient. Despite the latter benefit, the need for the RhD NIPD technology introduction into clinical practice at the population level is questionable. This test is a technology push product rather than a market-driven development and is characterised by high implementation costs and no clinical impact on the decrease of sensitisations and HDFN (haemolytic disease of fetus and newborn) cases in countries where antenatal anti-D is implemented. However, scientists argue the importance of this test in clinical practice.We employ systems thinking and simulation modelling to assess the potential and the impact of this test. This work describes the development of a game simulator for clinicians and policymakers. We hope it will serve as a useful decision-making tool for evaluation of RhD NIPD adoption scenarios.