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Non-invasive prenatal testing for fetal rhesus-D status - putting the NICE guidance into practice

Courtesy of NICE

You may already be aware that last November, NICE published guidance on non-invasive prenatal testing for fetal rhesus-D status. This guidance recommended a new blood test for all pregnant women with a rhesus-D negative blood type, which could help thousands avoid unnecessary treatment. 

NICE has published a new adoption resource, which will help health care professionals to put this guidance into practice.  

The NICE guidance: High-throughput non-invasive prenatal testing for fetal RHD genotype

Women who are rhesus-D negative are missing a substance called D antigen on their red blood cells. If they become pregnant and their baby is rhesus-D positive (has the D antigen on their blood cells), blood cells from the baby that transfer into the bloodstream of the mother can cause the mother’s immune system to produce antibodies to the baby’s blood, a process called sensitisation. The first pregnancy is not usually dangerous but if a second baby is also rhesus-D positive these antibodies can attack the blood cells of the unborn baby. This condition, called haemolytic disease of the fetus and newborn, affects about 500 babies each year in England and can cause the stillbirths, disability or death from anaemia and jaundice.

NICE recommends a new test in pregnancy that analyses the baby’s DNA found in its mother’s bloodstream to establish what blood group it is – if it’s different to that of its mother it can cause serious complications. The test, called High-throughput, non-invasive prenatal testing(NIPT), was developed by NHS Blood and Transplant and can be performed during routine antenatal appointments. Currently all women whose blood tests show they are rhesus-D negative are given an injection of anti-D immunoglobulin to reduce the risk of potential problems in future pregnancies. But only those whose baby is rhesus-D positive actually need it. However until now there has not been a reliable way of testing the rhesus status of the baby before it’s born. By ensuring anti-D immunoglobulin is only given to women who need it, the test has the potential to protect stocks of this finite resource and save the NHS more than £500,000 each year.

The new NICE adoption resource: NICE diagnostics adoption support for high-throughput non-invasive prenatal testing for fetal RHD genotype –Insights from the NHS

Our new adoption resource has been designed to support health professionals who are planning to implement the NICE recommended High-throughput NIPT within their own care pathways. The resource includes real-life advice and examples of how NHS sites have adopted this test and has been created with the help of NHS clinicians, who have reported that benefits of implementing it include:

Your Comments

Charles Anto
23 May 2017
2:52 pm

This is a win, win for all parties involved i.e mothers, babies, hospitals and healthcare professionals. It is brilliant!

Jennelyn Valerio
3 Jul 2017
10:35 am

This is very good and practical!It will indeed save the NHS a lot of money by this procedure.It will save time as well, not having to run a sample for four cell screen or having to send it to an RCI lab for anti- D quantification to rule out immune anti - D.

15 Nov 2017
3:35 pm

But finding somewhere that offers this test (which I am trying to do for myself) is pretty much impossible either NHS or privately!!

16 Nov 2017
12:00 pm

Does anyone know where to get this testing done?

21 Feb 2020
3:08 am