Two Reliable Methodical Approaches for Non-Invasive RHD Genotyping of a Fetus from Maternal Plasma

摘要

Noninvasive fetal genotyping is an important tool for predicting RhD incompatibility between a pregnant woman and a fetus. This study aimed to assess a methodological approach other than the commonly used one for noninvasive fetal genotyping on a representative set of RhD-negative pregnant women. The methodology must be accurate, reliable, and broadly available for implementation into routine clinical practice. A total of 337 RhD-negative pregnant women from the Czech Republic region were tested in this study. The fetal genotype was assessed using two methods: real-time PCR and endpoint quantitative fluorescent (QF) PCR. We used exon-7-specific primers from the gene, along with internal controls. Plasma samples were analyzed and measured in four/two parallel reactions to determine the accuracy of the genotyping. The genotype was verified using DNA analysis from a newborn buccal swab. Both methods showed an excellent ability to predict the genotype. Real-time PCR achieved its greatest accuracy of 98.6% (97.1% sensitivity and 100% specificity (95% CI)) if all four PCRs were positiveegative. The QF PCR method also achieved its greatest accuracy of 99.4% (100% sensitivity and 98.6% specificity (95% CI)) if all the measurements were positiveegative. Both real-time PCR and QF PCR were reliable methods for precisely assessing the fetal allele from the plasma of RhD-negative pregnant women.