Inherited red cell disorders in pregnancy

Who to refer:

Please refer:

• Patients with clinically significant haemoglobinopathies^*
• Couples at high risk of having a child with a clinically significant haemoglobinopathy (prenatally or antenatally)^¥
• Patients with thalassaemia traits (alpha or beta) and proven iron deficiency prior to commencing iron supplementation
• Patients with confirmed unstable Hb, HS, G6PD or PK deficiency.

*Hb SS, Hb SC, Hb S/D Punjab, Hb S/O Arab, Hb S/Lepore, Hb S/ B thal, Hb S/DBthal, Beta thalassaemia major, Hb E/B thal, Hb B thal/Lepore, Hb H disease.

^¥Both partners are haemoglobinopathy carriers, one affected partner and other haemoglobinopathy carrier, both partners have clinically significant haemoglobinopathy.

Please note that letters explaining the haemoglobinopathy trait and any actions required will be automatically generated and sent to the requestor and patient information will be sent to the patient.

Who not to refer:

• Haemoglobinopathy carriers if partner (1) does not have a clinically significant haemoglobinopathy or (2) is not also a haemoglobinopathy carrier
• Patients with thalassaemia traits who are not iron deficient

How to refer:

SCI Gateway to Department of Haematology BGH to decide if onward referral to RIE appropriate. 

Who to investigate:

see above

Primary Care Investigations:

• FBC, Blood film
• Haemoglobinopathy Screen (HPLC)
• Ferritin
• G6PD or PK screen, if family history

• For haemoglobinopathy carrier information leaflets or inheritance risk chart please see Sickle cell and thalassaemia screening: commission and provide – GOV.UK (www.gov.uk)
• NHS Sickle Cell and Thalassaemia Screening Programme – Sickle Cell and Thalassaemia Handbook for Laboratories: http://sct.screening.nhs.uk/standardsandguidelines