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Routine antenatal determination of fetal rhesus (RH) D status using cell free fetal dna in the maternal circulation: women and health professionals' attitudes
  1. D Warner1,
  2. C Compton1,
  3. K McCall1,
  4. L S Chitty1,2
  1. 1Fetal Medicine Unit, UCLH NHS Foundation Trust, London, UK
  2. 2UCL Institute of Child Health, London, UK

Abstract

Background Analysis of free fetal DNA (cffDNA) in D- pregnant womens' blood can predict fetal D type. If introduced into routine antenatal care it is likely to significantly reduce anti-D administration as D– women carrying a D– fetus will not require immunoprophylaxis. As part of a larger scale evaluation of this technology we are performing a survey of women and health professionals attitudes towards this technology.

Methods Research midwives conducted separate focus groups of 8–10 D- pregnant women, midwives or obstetricians, using a semi-structured approach designed to ascertain perceptions of the current antenatal care of D-negative women and explore women's and health professionals attitudes to the advantages and disadvantages of the possible implementation of routine cffDNA testing. The focus groups are audiotaped, transcribed verbatim and analysed using thematic analysis to inform the development of a questionnaire for wider distribution.

Results Preliminary results indicate that the majority of D- women are keen to avoid administration of anti-D if possible. However, they would prefer any cffDNA testing to be done at the time of a routine clinic visit and consider that careful explanation of the new test will be required.

Conclusions Pregnant women are likely to welcome the introduction of cffDNA testing to determine fetal D status if this reduces need for anti-D administration. However, this will need to be accompanied by widespread education of health professionals, especially midwives. The results of this study will be used to inform the development of patient and healthcare professional information leaflets and education.

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