Foreword
1st Edition, November 2023
This Guidance from a clinical expert reference group convened by ANZSBT provides advice to clinical health professionals and pathology laboratories to optimise use and interpretation of RHD NIPT.
The development of the Guidance for RHD non-invasive prenatal testing (NIPT) for fetal RhD blood group prediction in pregnancy, a national roadmap for the safe and appropriate introduction of RHD NIPT and associated clinical care pathways and brochures was supported by a Quality Use of Pathology Program (QUPP) Grant (4-GZS2YFL) from the Australian Government Department of Health.
Scope
This guidance document supports safe practices for services and organisations wishing to introduce RHD NIPT as part of the pregnancy care pathway. The intention is to ensure that RhD negative women who require RhD Ig receive the intended prophylaxis throughout their pregnancy and at the birth of their baby. The guidance refers to fetal RHD NIPT recommended for RhD negative women who have no preformed red cell RhD antibodies. Women with preformed clinically significant antibodies (for example anti-D, -c, -C, -E, -K, -k, -Fya, -Fyb) or weak/partial D groups will require specific testing (see Section 2.2 clinical pathways).
It is acknowledged that service variation may require local adaption of resources and policies, with the aim of the guideline to provide a generalised approach to practice that can be applied to all maternity care models, regardless of their location in Australia and the patient population for whom they provide care.
Summary of Amendments
Guideline updated to reflect changes in nomenclature of Variant D phenotypes
- Please refer to the following sections:
- 1 – Indication and timing of RHD NIPT during pregnancy
- FP3 – Flow pathway for RHD NIPT for RhD negative women in pregnancy
- FP5 – Flow pathway for women with a known Variant D (weak or partial D) blood group
- 4.3.2 Risks of RHD NIPT
- Please refer to the following sections: