Routine administration of Anti-D: the ethical case for offering pregnant women fetal RHD genotyping and a review of policy and practice.
Routine administration of Anti-D: the ethical case for offering pregnant women fetal RHD genotyping and a review of policy and practice.
复制标题
抗D的常规管理：为孕妇提供胎儿RHD基因分型的道德案例和对政策和实践的审查。
DOI：
10.1186/1471-2393-14-87
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发表时间：
2014-02-25
影响因子：
3.1
通讯作者：
Soothill P
中科院分区：
文献类型：
--
作者：
Kent J;Farrell AM;Soothill P
自20世纪60年代引入抗D免疫球蛋白（抗D IG）以来，在降低胎儿和新生儿溶血病（HDFN）的发生率以及改善孕产妇和胎儿健康方面取得了巨大成功。它保护妇女在怀孕期间免受其他侵入性干预，防止新生儿死亡和伤害，是一项已在世界范围内采用的技术。目前，英国约三分之一的Rhesus D（RhD）血型阴性的孕妇（英格兰和威尔士每年约有40，000名妇女）在怀孕期间接受产前抗D IG，因为她们怀的是RhD阴性胎儿。自1997年以来，已经开发了一种使用母体血液中无细胞胎儿DNA（cffDNA）的测试来鉴定胎儿的基因型，并可用于预测胎儿RhD血型。本文考虑了当使用母体血液进行胎儿RHD基因分型可以识别出不需要该产品的妇女时，继续对所有RhD阴性妇女进行产前抗D IG给药在伦理上是否可以接受。三分之一携带RhD阴性胎儿的RhD阴性孕妇产前给予抗D IG，因此不需要它引起了重要的伦理问题。如果对所有RhD阴性孕妇提供使用母血进行胎儿RHD基因分型，将有助于她们对是否进行产前抗D IG免疫球蛋白进行知情选择。
Since its introduction in the 1960s Anti-D immunoglobulin (Anti-D Ig) has been highly successful in reducing the incidence of haemolytic disease of the fetus and newborn (HDFN) and achieving improvements to maternal and fetal health. It has protected women from other invasive interventions during pregnancy and prevented deaths and damage amongst newborns and is a technology which has been adopted worldwide. Currently about one third of pregnant women with the blood group Rhesus D (RhD) negative in the UK (approximately 40,000 women per year in England and Wales), receive antenatal Anti-D Ig in pregnancy when they do not require it because they are carrying a RhD negative fetus. Since 1997, a test using cell free fetal DNA (cffDNA) in maternal blood has been developed to identify the genotype of the fetus and can be used to predict the fetal RhD blood group. This paper considers whether it is ethically acceptable to continue administering antenatal Anti-D Ig to all RhD negative women when fetal RHD genotyping using maternal blood could identify those women who do not need this product. The antenatal administration of Anti-D Ig to a third of RhD negative pregnant women who carry a RhD negative fetus and therefore do not need it raises important ethical issues. If fetal RHD genotyping using maternal blood was offered to all RhD negative pregnant women it would assist them to make an informed choice about whether or not to have antenatal Anti-D Ig.
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影响因子：
2.9
作者：
Finning, KM;Martin, PG;Avent, ND
通讯作者：
Avent, ND
影响因子：
1.5
作者：
Harkness, M.;Freer, Y.;Warner, P.
通讯作者：
Warner, P.
影响因子：
2.9
作者：
Clausen, Frederik Banchpdf;Christiansen, Mette;Dziegiel, Morten Hanefeld
通讯作者：
Dziegiel, Morten Hanefeld
DOI：
10.1111/1471-0528.12175
发表时间：
2013-06-01
影响因子：
5.8
作者：
Bolton-Maggs, P. H. B.;Davies, T.;Cohen, H.
通讯作者：
Cohen, H.
影响因子：
--
作者：
Finning, Kirstin;Martin, Pete;Daniels, Geoff
通讯作者：
Daniels, Geoff