Testing of maternal blood to determine fetal RHD genotype

The Guideline for the prophylactic use of Rh D immunoglobulin in pregnancy care (2.63 MB) (the Guideline) was released in May 2021.   

The Guideline includes a recommendation for non-invasive prenatal testing (NIPT) for fetal RHD in all Rh D negative pregnant women to enable targeted antenatal Rh D immunoprophylaxis (Recommendation 9 (933.49 KB)). 

This recommendation is based on scientific evidence and consensus among clinical experts and is not a policy statement on funding and supply arrangements for the national provisions of NIPT. 

NIPT is currently publicly funded for high-risk pregnancies in the following categories: 

  1. High-risk Rh D negative pregnant women who are anti-D alloimmunised; 
  2. High-risk Rh D negative pregnant women with obstetric indications such as severe fetal maternal haemorrhage during pregnancy; or 
  3. Other unusual but rare scenarios such as allergy to the anti-D immunoglobulin. 

Requests for testing in these high-risk women will continue to come from an obstetrician or other treating clinician to the Australian Red Cross Lifeblood (Lifeblood). Lifeblood will continue NIPT testing for high-risk pregnancies until decisions are made by government on the funding and supply arrangements for fetal RHD for all Rh D negative pregnant women. 

These funding and supply arrangements for fetal RHD are currently being considered by government following the Medical Services Advisory Committee’s (MSAC) support for the creation of new MBS items for NIPT for fetal rhesus D genotype in both low-risk women who have not been isoimmunised and high-risk women who have been previously isoimmunised (MSAC Application 1574). Further details are provided at www.msac.gov.au/internet/msac/publishing.nsf/Content/1574-public.

The decision to list items on the MBS is subject to the usual process of government consideration and is not yet finalised.