The implementation of a non-invasive Rhesus hemolytic disease of the fetus and newborn (HDFN) screening program in Ireland resulted in over 7,000 women avoiding unnecessary anti-D prophylaxis therapy, demonstrating the feasibility of this approach to antenatal care. This study was recently published in Vox Sanguinis.
The program was established to offer RHD screening services to pregnant women who were Rhesus D negative from 11 weeks of gestation onwards. This national program started in 2019 and has been running for six years.
Read more about HDFN testing and diagnosis
Researchers sought to evaluate how this service has impacted pregnancy outcomes since it was established. From 2019 to 2024, testing was performed on 20,099 samples. A predicted Rhesus D positive result was found in 11,699 cases (58.2%); this meant that Rhesus incompatibility leading to HDFN was a distinct possibility.
Researchers estimated that this non-invasive test had excellent statistical sensitivity (99.94%) and specificity (99.40%). A total of 0.2% cases were deemed false-positives, a figure similar to those seen in other studies.
Over the course of this initiative, 7,400 women were able to avoid unnecessary anti-D treatment, translating to savings of approximately $638,000.
“Due to the success of fetal RHD screening, cord blood testing [ie, testing for Rhesus HDFN after birth using samples obtained from the umbilical cord blood of the newborn] has been discontinued in some countries; a practice which could be reviewed in Ireland,” the authors of the study wrote.
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