Abstract
Despite the use of Rh-immunoglobulin prophylaxis for the past 30 years, anti-RhD in RhD-negative women is still the most common cause of severe haemolytic disease of the newborn and fetus (HDN). 1 Mollison PL Engelfriet CP Contreras M Blood transfusion in clinical medicine, 10th edition. Blackwell Science, Oxford1997 Google Scholar Two genes encode the antigens of the Rh system: RHD encodes the RhD antigen; RHCE encodes the RhCc and RhEe antigens. These two genes are highly homologous, each consisting of 10 exons. It is generally accepted that the RhD-negative phenotype results from an absence of RHD; that is, RhD-negative people are homozygous for a deletion of RHD. 2 Colin Y Chérif-Zahar B Le Van Kim C et al. Genetic basis of the RhD-positive and RhD-negative blood group polymorphism as determined by Southern analysis. Blood. 1991; 78: 2747-2752 Crossref PubMed Google Scholar Several PCR-based techniques have been developed to determine the presence of RHD in genomic DNA in order to predict the RhD type of the red cells (reviewed in ref 3). Such tests are now regularly used to ascertain fetal RhD type from amniocyte DNA obtained by amniocentesis of RhD-negative pregnant women with anti-RhD in their plasma. In such circumstances an RhD-positive fetus would be at risk from HDN, whereas an RhD-negative fetus would not.
Published Version
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