The Guideline for the prophylactic use of Rh D immunoglobulin in pregnancy care (2.63 MB) (2.63) (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) (933.49KB)).
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 also known as non-invasive prenatal analysis or NIPA.
NIPT is currently performed by the Australian Red Cross Lifeblood and publicly funded for high-risk pregnancies in the following categories:
- High-risk Rh D negative pregnant women who are anti-D alloimmunised;
- High-risk Rh D negative pregnant women with obstetric indications such as severe fetal maternal haemorrhage during pregnancy; or
- Other unusual but rare scenarios such as allergy to the anti-D immunoglobulin.
Requests for testing in these high-risk women need to come from an obstetrician or other treating clinician to the Australian Red Cross Lifeblood (Lifeblood). For more information on the test from Lifeblood go to Red cell reference | Lifeblood.
Lifeblood is approved to continue providing this test under the national blood arrangements for high-risk pregnancies until alternative services become available as part of the normal provision of pathology services.
The Royal College of Pathologists of Australasia, with support from Lifeblood, successfully applied to the Commonwealth Government for funding of a test in two settings under the usual Medicare arrangements.
• Non invasive prenatal testing of blood from an RhD negative pregnant patient for the detection of the RHD gene from fetal DNA circulating in maternal blood – MBS Item number 73420.
• Non invasive prenatal testing of blood from an RhD negative pregnant patient (in a singleton pregnancy) for the detection of the RHD gene from fetal DNA circulating in maternal blood, if the patient is alloimmunised with immune Anti-D MBS Item number 73421.
After assessment of the proposal in the usual way by the Medical Services Advisory Committee, the inclusion of the test for the two settings under Medicare was approved. Medicare Items for these services from pathologists is available from 1st July 2022. Further details are provided at MBS online - MBS Online.
Further questions about availability of the test are best directed to your local pathology provider from your obstetrician or other treating clinician.