The Norwegian experience with nationwide implementation of fetal RHD genotyping and targeted routine antenatal anti-D prophylaxis

Autor:	Barbora Jacobsen, Kristin Gjerde Hagen, Çiğdem Akalın Akkök, Tatjana Sundic, Aud Norunn Ulvahaug, Kirsten Sørensen, Aurora Espinosa, Abid Hussain Llohn, Mirajana Grujic Arsenovic, Geir Tomter, Ingvild Hausberg Sørvoll, Mette S Baevre
Rok vydání:	2021
Předmět:	medicine.medical_specialty Genotype Rho(D) Immune Globulin MEDLINE Norwegian 030204 cardiovascular system & hematology Rh Isoimmunization 03 medical and health sciences Maternity care 0302 clinical medicine Fetus Pregnancy Prenatal Diagnosis medicine Anti d prophylaxis Humans Maternal Health Services Genotyping Rh-Hr Blood-Group System Obstetrics business.industry Hematology medicine.disease language.human_language language Gestation Female business 030215 immunology
Zdroj:	Transfusion medicine (Oxford, England)REFERENCES. 31(5)
ISSN:	1365-3148
Popis:	Objectives To reduce the risk of RhD alloimmunization during the last trimester of pregnancy, a targeted routine antenatal anti-D prophylaxis (RAADP) programme was implemented in Norway in 2016. Here, we present and discuss our experience with the nationwide implementation of the programme, and report sample uptake and preliminary data of de novo anti-D in pregnancy. Background The targeted RAADP was advised by the academic community and evaluated by the health authorities. A National Working Group has conducted the implementation in the transfusion services and contributed to organise the administration of the antenatal anti-D prophylaxis. Fetal RhD type is determined by non-invasive prenatal testing at gestational week 24, and anti-D prophylaxis is administrated at gestational week 28 only to women with RhD positive fetuses. Methods We describe the implementation process of targeted RAADP in Norway. The sample uptake is calculated by comparing the number of fetal RHD screens with the expected number of samples. Results The sample uptake shows regional variations: 88%-100% after 3 years. Promising decrease in de novo anti-D detected during pregnancy is observed. Conclusions Nationwide targeted RAADP is implemented and included in the Norwegian maternity care programme. Compliance to sample uptake should further improve in some regions. A remaining issue to fulfil is the documentation of the accuracy of the fetal RHD-typing at all sites. Post-natal prophylaxis will then be guided by the fetal RHD result. Dedicated registries will ensure data to evaluate the expected reduction in pregnancy-related RhD immunisations, which is the final success criterion of the programme.
Databáze:	OpenAIRE
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