Third trimester screening for blood group antibodies in Rhesus c-negative pregnant women

Third trimester screening for blood group antibodies in Rhesus c-negative pregnant women has proven to be effective. The Health Council of the Netherlands concludes that the screening offers substantial health benefits while posing minimal disadvantages. However, according to the Council, third trimester screening is not necessary for women in their first pregnancy. The likelihood of developing blood group antibodies later in pregnancy is negligible in these cases. As a result, the Council recommends offering third trimester screening only to Rhesus c-negative women who have been pregnant before.

In the Netherlands, all pregnant women are offered blood testing during the first trimester. One of the goals of this prenatal screening is to detect blood group antibodies. If a pregnant woman develops antibodies against her unborn child’s red blood cells, it can lead to serious illness and even death of the (unborn) child. Early detection and treatment are critical to preventing such outcomes.

While all pregnant women undergo blood screening in the first trimester, a second test in the third trimester is offered only to Rhesus D-negative and Rhesus c-negative pregnant women who did not have detectable antibodies in their first test. The Ministry of Health, Welfare and Sport requested advice from the Health Council of the Netherlands on whether third trimester screening for Rhesus c-negative pregnant women should be continued in its current form. In response, the Council’s Standing Committee on Preconception, Prenatal and Neonatal Screening has reviewed the matter.

The Committee concluded that third trimester screening for blood group antibodies in Rhesus c-negative pregnant women is effective and should be continued. It provides substantial health benefits for the (unborn) child while posing minimal disadvantages. However, the Committee recommends narrowing the target population to Rhesus c-negative pregnant women who have had at least one previous pregnancy. Since the risk of late antibody formation in first pregnancies is minimal, this more targeted approach ensures that screening is offered to those who are most likely to benefit from it.