Genotipagem RhD fetal não invasiva – impacto económico na profilaxia da isoimunização RhD na gravidez

Abstract

Overview and Aims: The introduction of antenatal RhD isoimmunization prophylaxis was of utmost importance in decreasing the prevalence of perinatal haemolytic disease. Noninvasive genotyping of fetal RhD group from mothers' plasma allows administration of anti-D immunoglobulin only to pregnant women with RhD positive fetuses. Aim: To analyse the economic impact of this technique in a population of nonisoimmunized pregnant women in comparison to the current practice of systematic RhD isoimmunization prophylaxis. Study design: Retrospective, observational and analytic study. Population: 9272 pregnant women who performed obstetric ultrasound in our Fetal Medicine and Prenatal Diagnosis Department between January 2007 to December 2012. Methods: The costs of systematic RhD isoimmunization prophylaxis were compared to fetal RhD genotyping and further RhD isoimunization of RhD negative mothers whose fetuses were RhD positive. Results:In the studied population, 16.7% of pregnant women were RhD negative and 40.3% of their offspring were also RhD negative. Concerning the economic analysis, selective administration of anti-D immunoglobulin based on fetal genotyping would have been about 62 euros more expensive per pregnancy than the current practice of antenatal immunoprophylaxis. Conclusion: Although non-invasive genotyping of fetal RhD group is undoubtly associated with innumerous benefits, in a merely economic analysis, this method is more expensive than the systematic immunoprophylaxis.info:eu-repo/semantics/publishedVersio