Abstract
Background This prospective cohort study evaluated the usefulness of conventional PCR in genotyping fetal Rhesus D (RhD) and sex from the maternal plasma of RhD-negative (RhD−) antenatal population in resource-limited settings. Methods Thirty apparently healthy RhD− pregnant women with RhD positive (RhD+) partners were included. Blood samples were collected from each participant (in the third trimester of pregnancy) for DNA extraction/purification and fetal RhD genotyping. Results Out of the 30 samples, 26 (86.7%) were found to be RhD+ while 4 (13.3%) were RhD−. The RhD+ comprised 24 (80.0%) RhD+ based on exons 5, 7, and 10 combined. Exons 5 and 7 were detected in two additional samples but not exon 10. Serological phenotyping of neonatal blood confirmed 26 RhD+ and 4 RhD−. There was a perfect agreement between the fetal RhD genotype and neonatal RhD phenotyping after delivery for exons 5 and 7 (concordance = 100%, κ = 100.0%, diagnostic accuracy = 100%, p < 0.0001) while exon 10 presented with an almost perfect agreement (concordance = 93.3%, κ = 76.2%, diagnostic accuracy = 93.3%, p < 0.0001). Regarding the prenatal test for the SRY gene, 9 (30.0%) were predicted to be males and the remaining 21 (60.0%) were females. All the 9 and 21 anticipated males and females, respectively, were confirmed after delivery (concordance = 100%, κ = 100.0%, diagnostic accuracy = 100%). Conclusion Our study suggests that conventional PCR using the SRY, RhD exons 5 and 7 could be useful for predicting fetal sex and RhD from maternal peripheral blood in resource-limited settings.
Highlights
Background eRhesus (Rh) blood group system is one of the most polymorphic and immunogenic systems known in humans
Our study suggests that conventional PCR using the SRY, Rhesus D (RhD) exons 5 and 7 could be useful for predicting fetal sex and RhD from maternal peripheral blood in resource-limited settings
Many healthcare facilities in developing countries embrace the practice of administering anti-D immunoglobulin prophylaxis to all RhD-negative pregnant women with RhD positive partners irrespective of fetus RhD status. ough useful as there have been drastic reductions in the incidence of RhD immunization since the inception of the anti-D immunoglobulin prophylaxis, the disadvantages associated with unsighted administration of the prophylaxis underpin the need for prenatal fetal RhD genotyping. is study evaluated the expediency of the less expensive conventional PCR for fetal sex and RhD genotyping in resource-limited settings
Summary
Background eRhesus (Rh) blood group system is one of the most polymorphic and immunogenic systems known in humans. Is prospective cohort study evaluated the usefulness of conventional PCR in genotyping fetal Rhesus D (RhD) and sex from the maternal plasma of RhD-negative (RhD− ) antenatal population in resource-limited settings. Blood samples were collected from each participant (in the third trimester of pregnancy) for DNA extraction/purification and fetal RhD genotyping.
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