{"id":4049,"date":"2022-05-03T11:47:20","date_gmt":"2022-05-03T10:47:20","guid":{"rendered":"https:\/\/apps.nhslothian.scot\/refhelp\/guidelines\/inheritedredcelldisordersinpregnancy\/"},"modified":"2023-08-31T14:31:29","modified_gmt":"2023-08-31T13:31:29","slug":"inheritedredcelldisordersinpregnancy","status":"publish","type":"page","link":"https:\/\/apps.nhslothian.scot\/refhelp\/guidelines\/haematology\/haematology-pregnancy-preconception\/inheritedredcelldisordersinpregnancy\/","title":{"rendered":"Inherited red cell disorders in pregnancy"},"content":{"rendered":"\n<title>Inherited red cell disorders in pregnancy<\/title>\n\n\n\n<p><strong><u>Inherited red cell disorders in pregnancy include<\/u><\/strong><strong>:<\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Haemoglobinopathy eg sickle cell disease or thalassaemia including trait<\/li>\n\n\n\n<li>Enzymopathy eg G6PD or pyruvate kinase deficiency<\/li>\n\n\n\n<li>Membranopathy eg hereditary spherocytosis (HS)<\/li>\n\n\n\n<li>Unstable Haemoglobins eg Hb Koln.<\/li>\n<\/ul>\n\n\n\n<p>Anaemia and haemolysis associated with these conditions may worsen during pregnancy and will require monitoring in the joint Haem-Obs clinics at RIE or SJH.<\/p>\n\n\n\n<p><strong><u>Who to investigate<\/u><\/strong>:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Patients with red cell microcytosis and hypochromia, with or without anaemia, who have a normal ferritin level<\/li>\n\n\n\n<li>Patients whose blood film comments recommend haemoglobinopathy or enzymopathy screening<\/li>\n\n\n\n<li>Patients with jaundice, anaemia, reticulocytosis, raised bilirubin and LDH with a known family history of a red cell disorder.<\/li>\n<\/ul>\n\n\n\n<p><span><br><\/span><strong>C.M &amp; L.W 31-07 23<\/strong><\/p>\n\n\n\n<div class=\"wp-block-getwid-tabs\" data-active-tab=\"0\"><ul class=\"wp-block-getwid-tabs__nav-links\"><\/ul>\n<div class=\"wp-block-getwid-tabs__nav-link\"><span class=\"wp-block-getwid-tabs__title-wrapper\"><a href=\"#\"><span class=\"wp-block-getwid-tabs__title\">Referral Guidelines<\/span><\/a><\/span><\/div><div class=\"wp-block-getwid-tabs__tab-content-wrapper\"><div class=\"wp-block-getwid-tabs__tab-content\">\n<h4 class=\"wp-block-heading\">Who to refer:<\/h4>\n\n\n\n<p><strong>Please refer:<\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Patients with clinically significant haemoglobinopathies<strong><sup>*<\/sup> <\/strong><strong><\/strong><\/li>\n\n\n\n<li>Couples at high risk of having a child with a clinically significant haemoglobinopathy (prenatally or antenatally)<strong><sup>\u00a5<\/sup><\/strong><strong><\/strong><\/li>\n\n\n\n<li>Patients with thalassaemia traits (alpha or beta) and proven iron deficiency prior to commencing iron supplementation<strong><\/strong><\/li>\n\n\n\n<li>Patients with confirmed unstable Hb, HS, G6PD or PK deficiency.<strong><\/strong><\/li>\n<\/ul>\n\n\n\n<p><em>*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.<\/em><em><\/em><\/p>\n\n\n\n<p><strong><sup>\u00a5<\/sup><\/strong><em>Both partners are haemoglobinopathy carriers, one affected partner and other haemoglobinopathy carrier, both partners have clinically significant haemoglobinopathy.<\/em><\/p>\n\n\n\n<p>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.<strong><em><\/em><\/strong><\/p>\n\n\n\n<h4 class=\"wp-block-heading\">Who not to refer:<\/h4>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Haemoglobinopathy carriers if partner&nbsp; (1) does not have a clinically significant haemoglobinopathy or (2) is not also a haemoglobinopathy carrier<\/li>\n\n\n\n<li>Patients with thalassaemia traits who are not iron deficient<\/li>\n<\/ul>\n\n\n\n<h4 class=\"wp-block-heading\">How to refer:<\/h4>\n\n\n\n<p>SCI Gateway to Department of Haematology RIE or SJH.<\/p>\n<\/div><\/div>\n\n\n\n<div class=\"wp-block-getwid-tabs__nav-link\"><span class=\"wp-block-getwid-tabs__title-wrapper\"><a href=\"#\"><span class=\"wp-block-getwid-tabs__title\">Primary Care Management<\/span><\/a><\/span><\/div><div class=\"wp-block-getwid-tabs__tab-content-wrapper\"><div class=\"wp-block-getwid-tabs__tab-content\">\n<h4 class=\"wp-block-heading\">Who to investigate:<\/h4>\n\n\n\n<p>see above<\/p>\n\n\n\n<h4 class=\"wp-block-heading\">Primary Care Investigations:<\/h4>\n\n\n\n<ul class=\"wp-block-list\">\n<li>FBC, Blood film<\/li>\n\n\n\n<li>Haemoglobinopathy Screen (HPLC)<\/li>\n\n\n\n<li>Ferritin<\/li>\n\n\n\n<li>G6PD or PK screen, if family history<\/li>\n<\/ul>\n<\/div><\/div>\n\n\n\n<div class=\"wp-block-getwid-tabs__nav-link\"><span class=\"wp-block-getwid-tabs__title-wrapper\"><a href=\"#\"><span class=\"wp-block-getwid-tabs__title\">Resources and Links<\/span><\/a><\/span><\/div><div class=\"wp-block-getwid-tabs__tab-content-wrapper\"><div class=\"wp-block-getwid-tabs__tab-content\">\n<ul class=\"wp-block-list\">\n<li>For haemoglobinopathy carrier information leaflets or inheritance risk chart please see&nbsp;<a href=\"https:\/\/www.gov.uk\/government\/collections\/sickle-cell-and-thalassaemia-screening-commission-and-provide\">Sickle cell and thalassaemia screening: commission and provide &#8211; GOV.UK (www.gov.uk)<\/a><\/li>\n\n\n\n<li>NHS Sickle Cell and Thalassaemia Screening Programme &#8211;&nbsp;<em>Sickle Cell and Thalassaemia Handbook for Laboratories<\/em>: <strong><u><a href=\"http:\/\/sct.screening.nhs.uk\/standardsandguidelines\">http:\/\/sct.screening.nhs.uk\/standardsandguidelines<\/a><\/u><\/strong><\/li>\n<\/ul>\n\n\n<\/div><\/div>\n<\/div>\n","protected":false},"excerpt":{"rendered":"<p>Inherited red cell disorders in pregnancy Inherited red cell disorders in pregnancy include: Anaemia and haemolysis associated with these conditions may worsen during pregnancy and will require monitoring in the joint Haem-Obs clinics at RIE or SJH. Who to investigate: C.M &amp; L.W 31-07 23<\/p>\n","protected":false},"author":2,"featured_media":0,"parent":15929,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"categories":[261],"class_list":["post-4049","page","type-page","status-publish","hentry","category-inheritedredcelldisordersinpregnancy"],"publishpress_future_workflow_manual_trigger":{"enabledWorkflows":[]},"rttpg_featured_image_url":null,"rttpg_author":{"display_name":"NHS Lothian","author_link":"https:\/\/apps.nhslothian.scot\/refhelp\/author\/nhs-lothian\/"},"rttpg_comment":0,"rttpg_category":" <a href=\"https:\/\/apps.nhslothian.scot\/refhelp\/category\/haematology\/inheritedredcelldisorders\/inheritedredcelldisordersinpregnancy\/\" rel=\"tag\">Inherited red cell disorders in pregnancy<\/a>","rttpg_excerpt":"Inherited red cell disorders in pregnancy Inherited red cell disorders in pregnancy include: Anaemia and haemolysis associated with these conditions may worsen during pregnancy and will require monitoring in the joint Haem-Obs clinics at RIE or SJH. Who to investigate: C.M &amp; L.W 31-07 23","_links":{"self":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/4049","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/comments?post=4049"}],"version-history":[{"count":8,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/4049\/revisions"}],"predecessor-version":[{"id":16154,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/4049\/revisions\/16154"}],"up":[{"embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/15929"}],"wp:attachment":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/media?parent=4049"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/categories?post=4049"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}