Fetal Rhesus D Genotyping and Sex Determination from Maternal Plasma of Rhesus D-Negative Antenatal Population: The Usefulness of Conventional Polymerase Chain Reaction in Resource-limited Settings

الملخص EN

Background.

This prospective cohort study evaluated the usefulness of conventional PCR in genotyping fetal Rhesus D (RhD) and sex from the maternal plasma of RhD-negative (RhD−) antenatal population in resource-limited settings.

Methods.

Thirty apparently healthy RhD− pregnant women with RhD positive (RhD+) partners were included.

Blood samples were collected from each participant (in the third trimester of pregnancy) for DNA extraction/purification and fetal RhD genotyping.

Results.

Out of the 30 samples, 26 (86.7%) were found to be RhD+ while 4 (13.3%) were RhD−.

The RhD+ comprised 24 (80.0%) RhD+ based on exons 5, 7, and 10 combined.

Exons 5 and 7 were detected in two additional samples but not exon 10.

Serological phenotyping of neonatal blood confirmed 26 RhD+ and 4 RhD−.

There was a perfect agreement between the fetal RhD genotype and neonatal RhD phenotyping after delivery for exons 5 and 7 (concordance = 100%, κ = 100.0%, diagnostic accuracy = 100%, p<0.0001) while exon 10 presented with an almost perfect agreement (concordance = 93.3%, κ = 76.2%, diagnostic accuracy = 93.3%, p<0.0001).

Regarding the prenatal test for the SRY gene, 9 (30.0%) were predicted to be males and the remaining 21 (60.0%) were females.

All the 9 and 21 anticipated males and females, respectively, were confirmed after delivery (concordance = 100%, κ = 100.0%, diagnostic accuracy = 100%).

Conclusion.

Our study suggests that conventional PCR using the SRY, RhD exons 5 and 7 could be useful for predicting fetal sex and RhD from maternal peripheral blood in resource-limited settings.