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The introduction of anti-D prophylaxis has lowered the incidence of Rh isoimmunization dramatically, but routine administration is expensive, and use of products derived from pooled plasma is not without risk. Although screening for fetal RHD genes in maternal blood is noninvasive and has been available for some time, studies demonstrating the practicality of this approach have been lacking. Investigators in Sweden (a country that does not practice routine antenatal anti-D prophylaxis) evaluated maternal testing for cell-free fetal DNA in 4000 RhD-negative pregnant women. Results from maternal blood samples obtained at the first prenatal visit were analyzed against newborn blood group determined at delivery.
In all, 96% of maternal blood sam…