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首页> 外文期刊>Transfusion medicine >Implementation of high-throughput non-invasive prenatal testing for fetalRHDgenotype testing in England: Results of a cross-sectional survey of maternity units and expert interviews
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Implementation of high-throughput non-invasive prenatal testing for fetalRHDgenotype testing in England: Results of a cross-sectional survey of maternity units and expert interviews

机译：英格兰胎儿型无侵袭性产前试验的实施：产妇单位和专家访谈的横断面调查结果

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Background Previously, routine antenatal anti-D prophylaxis (RAADP) was administered to all RhD-negative mothers to reduce the risk of sensitisation in the UK's National Health Service (NHS). If the baby is RhD-negative, RAADP is not required. In 2016, the UK National Institute for Health and Care Excellence (NICE) recommended non-invasive prenatal testing (NIPT) for fetalRHDgenotype as a cost-effective option to guide RAADP. Objectives To evaluate the implementation of high-throughput NIPT for fetalRHDgenotype in maternity units in England by addressing research recommendations from the NICE. These were to reduce uncertainty around the resource use and cost of staff training, management of samples and results and record-keeping, as well as resultant changes to antenatal or post-partum care and performance of NIPT. Methods A cross-sectional survey was developed and sent to clinicians at 39 English NHS Trusts in May 2018. Qualitative interviews with seven individuals were conducted to explore missing or contraindicatory data. Qualitative findings were supplemented with NIPT test results (April 2017 to February 2019) from English hospitals. Results Staff reported that training took up to 30 minutes. There were no extra costs associated with sample management or additional appointments. Extra time required for record-keeping and management of test results was balanced later in the patient pathway. The antenatal pathway was not changed in the Trusts surveyed. The survey revealed that four post-partum scenarios were being used within English NHS Trusts. The frequency of inconclusive NIPT results was 4.3%. Conclusion NIPT for fetalRHDgenotype can be implemented without consuming substantial extra resources through incorporation into an existing patient pathway.
机译：背景技术先前，常规产前抗D预防预防（RAADP）给所有RHD阴性母亲施用，以降低英国国家卫生服务（NHS）致敏风险。如果婴儿是RHD阴性，则不需要RAADP。 2016年，英国国家健康和护理学院卓越（尼斯）推荐用于FETALRHDGENOTYA​​PT的无侵入性产前检测（NIPT）作为指导RAADP的成本效益选项。目的通过解决漂亮的研究建议，评估英格兰产妇单位的高通量Nipt的实施这些是减少周围的资源使用和工作人员培训的成本，样品和结果管理以及记录保存的不确定性，以及对产前或百次百分问护理的改变以及术后的效果。方法在2018年5月，开发了横断面调查并向临床医生发送到临床医生。进行了七个人的定性访谈，以探索缺失或禁止的数据。从英语医院辅以NIPT测试结果（2017年4月至2019年2月）的定性发现。结果人员报告说，培训最多30分钟。没有与样品管理或其他约会相关的额外费用。记录保存和测试结果所需的额外时间在患者途径后面平衡。在受调查的信托中，产前途径没有改变。该调查显示，英国NHS信托中使用了四个百分之一点情景。不确定的拼影结果的频率为4.3％。结论可以通过掺入现有的患者途径来实施无需消耗大量额外资源的胎儿RHDGANotype。

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