Sickle cell and Thalassaemia
The UK NSC policy on Sickle cell and Thalassaemia screening in pregnancy
More Information
Sickle Cell disorders are a group of inheritable genetic conditions in which there is an abnormality of the haemoglobin. Haemoglobin carries oxygen to the various organs of the body and is contained in the red blood cells. In the sickle cell disorders some of the red blood cells assume a sickle shape following the release of oxygen. This abnormal shape causes the cells to clump together making their passage through smaller blood vessels difficult, which may lead to blockage of these small blood vessels and an associated inflammatory reaction.
ß Thalassaemia major is a life threatening, genetically inherited, progressive anaemia common in the Mediterranean, Asian, South East Asian and Middle Eastern countries.
» Read more about sickle cell anaemia on the Contact a Family website
» Read more about thalassaemia major on the Contact a Family website
Policy Position
From April 2005, enhanced laboratory screening should be offered to all women in units defined as high prevalence. High prevalence is defined as a fetal prevalence of sickle cell disorder greater than 1.5 per 10,000 pregnancies.
From April 2007, all units defined as low prevalence (a fetal prevalence of sickle cell lower than 1.5 per 10,000 pregnancies) should offer screening using the recommended family origin question, as well as a formal process of inspection of routine blood indices to screen for thalassaemia.
This policy was reviewed in Jul 2006 but no significant changes were made. It is due to be considered again in 2009/10, or earlier if significant new evidence emerges.
Screening in the UK
Compare how screening is offered across the UK.
Evidence Supporting the Policy
Health Technology Assessment 2000; Vol. 4: No. 3. Screening for sickle cell disease and thalassaemia: a systematic review with supplementary research (Davies et al)
Health Technology Assessment 1999; Vol. 3: No. 11. Antenatal and neonatal haemoglobinopathy screening in the UK: review and economic analysis (Zeuner et al)
National Collaborating Centre for Women’s and Children’s Health. Commissioned by the National Institute for Health and Clinical Excellence. Antenatal care: routine care for the healthy pregnant woman. CG62: full guidance. March 2008 (corrected June 2008).
Stakeholders
Genetic Alliance UK
Royal College of General Practitioners
Royal College of Midwives
Royal College of Obstetricians and Gynaecologists
Sickle Cell Care Centre
Sickle Cell Society
UK Thalassaemia Society
The stakeholder groups will be involved when the policy is next reviewed. If you think your organisation should be added, please contact us.
