Non-invasive prenatal diagnosis of fetal RhD by using free fetal DNA

WOS: 000356108200017PubMed ID: 26152007Objective: Anti-D immunoglobulin is applied to all pregnant women having Rh]) incompatibility to prevent hemolytic disease of the newborn. The aim of this study is to determine fetal RE]) status in the Rh incompatible pregnancies with an non-invasive technique; free fetal DNA isolation from maternal circulation. In the case of Rh incompatibility especially with a history of previous fetal anemia, it can be beneficial to know Rh status antenatally in terms of monitoring fetuses with Rh positive [RhD(+)] status consciously. Materials and Methods: Total free DNA was isolated in 50 Rh negative [RhD()] pregnant women, who had Rh]) alloimmunisation with their husbands. The gene in isolated DNA was investigated with TagMan prob and real time PCR by using primers belonging to exon 7 of the RhD gene. Results: The authors analyzed 50 RhD() women by using quantitative real time PCR technique. Five of them were RhD() and the rest of them were found to be RhD(+). After birth one of the infants who were analyzed as RhD(+) were found to be RED(). Conclusion: The detection of fetal RED status by using a non-invasive method from maternal circulation was found to be possible. Assessing fetal RED status non-invasively by using free fetal DNA in maternal blood will be cost-efficient, avoiding unnecessary indirect Coombs test and unnecessary Rhogam applications that is used in RH incompatible pregnancies. This study will throw a fresh light on prenatal diagnosis

Multicentric experience on double dartos flap protection in tubularized incised plate urethroplasty for distal and midpenile hypospadias

Purpose: We report a multicenter experience using double dartos flap to protect the neourethra in TIP urethroplasty for distal and midpenile hypospadias. Methods: A total of 394 patients underwent tubularized incised plate urethroplasty for primary distal and midpenile hypospadias using double dartos flap protection by ten pediatric surgeons and urologists at five different institutions. Results: Tubularized incised plate urethroplasty protected by a double dartos flap was simple to perform and flaps were easy to obtain. Complications occurred in 23 patients (5.83%): fistulas 1.01% (4 cases), stenosis 0.25% (1 case), mild stenosis 2.53% (10 cases), dehiscence of ventral cutis 0.50% (2 cases) and penile torsion 1.26% (5 cases). All fistulae had a spontaneous resolution. Conclusion: Double dartos flap to protect tubularized incised plate urethroplasty is safe with a low complication rate. The neourethra is covered entirely with a double layer of vascularized tissue and the double coverage appears a good choice for preventing urethrocutaneous fistula formation. © 2011 Springer-Verlag