Antenatal haemoglobinopathy screening - Experiences of a large Australian Centre.

Obstet Med

Department of Haematology, NSW Health Pathology, Randwick, Australia.

Published: June 2021

Background: Antenatal screening is vital to identifying couples at risk of having children with a clinically significant haemoglobinopathy. In Australia, immigration is increasing carrier incidence.

Methods: A retrospective analysis was performed of full blood count, high-performance liquid chromatography and haemoglobin electrophoresis of women and their partners who underwent antenatal haemoglobinopathy screening over three years at a major NSW laboratory. Genetic testing results were included where available.

Results: One thousand six hundred and twenty-eight women and 729 male partners were screened at a median gestation of 14 weeks. 8.2% of women had a clinically significant result, with a median 16-day interval to partner testing. In 35% of couples screened simultaneously, the partner did not require testing. Genetic confirmatory testing was performed in 65% of high risk couples.

Conclusion: There was a significant delay to antenatal haemoglobinopathy screening for mothers, limiting time for genetic diagnosis, prenatal diagnosis and management of affected pregnancies. Screening should be performed earlier. Simultaneous couple testing is not cost-effective.

Download full-text PDF

Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8358238PMC
http://dx.doi.org/10.1177/1753495X20944708DOI Listing

Publication Analysis

Top Keywords

antenatal haemoglobinopathy
12
haemoglobinopathy screening
12
screening
5
testing
5
antenatal
4
screening experiences
4
experiences large
4
large australian
4
australian centre
4
centre background
4

Similar Publications

The roles of blood picture, haemoglobinopathy traits, and blood groups determined in routine antenatal tests in the screening for complications in pregnancy.

Best Pract Res Clin Obstet Gynaecol

December 2024

Department of Obstetrics & Gynaecology, The University of Hong Kong, Queen Mary Hospital, SAR, Hong Kong. Electronic address:

Routine antenatal tests include haemoglobin measurement, usually with red blood cell indices, white cell and platelet counts, and ABO and Rhesus blood groups, are aimed to screen for iron deficiency anaemia, carriage of haemoglobinopathy traits, and other forms of anaemia or other underlying but undiagnosed conditions. Iron deficiency anaemia has been associated with most of the common pregnancy complications including pre-eclampsia, preterm birth, antepartum and postpartum haemorrhage, low birthweight and small-for-gestational age infants, and impacts long-term neurocognitive and developmental outcomes in the offspring. Increased adverse pregnancy and perinatal outcomes are also found with high haemoglobin, thalassaemia and sickle cell traits, and the non-O blood groups especially group AB.

View Article and Find Full Text PDF

Position statement on the management of pregnancy in sickle cell disease.

Aust N Z J Obstet Gynaecol

September 2024

Schools of Medicine and Women's and Children's Health, Prince of Wales Hospital and Royal Hospital for Women Clinical School, University of NSW, Sydney, New South Wales, Australia.

Sickle cell disease (SCD) is a hereditary haemoglobinopathy which causes multi-organ dysfunction. Pregnancies in SCD are high risk with significant maternal and fetal morbidity and mortality, including vaso-occlusive crises, thrombosis, anaemia, placental insufficiency, fetal growth restriction, preterm birth and medication effects. High level evidence on this topic is lacking.

View Article and Find Full Text PDF

Nipocalimab in Early-Onset Severe Hemolytic Disease of the Fetus and Newborn.

N Engl J Med

August 2024

From Dell Medical School, University of Texas at Austin, and the Comprehensive Fetal Care Center, Dell Children's Medical Center - both in Austin (K.J.M.); Janssen Pharmaceuticals, Cambridge, MA (L.E.L., J.H.L., A.M., V.S., L.B.S., M.L.T., S.S.-K., Y.K.); the Departments of Obstetrics (D.O., E.J.T.J.V.) and Pediatrics (E.L.), Leiden University Medical Center, Leiden, the Netherlands; the Clinical Epidemiology Division, Department of Medicine Solna, Karolinska Institutet, Stockholm (E.T.); the Feto-Maternal Unit, Liverpool Hospital, Liverpool, NSW, Australia (J.S.); the Institute for Clinical Immunology and Transfusion Medicine, Justus Liebig University (U.J.S., G.B.), and the Department of Thrombosis and Hemostasis, Giessen University Hospital (U.J.S.) - both in Giessen, Germany; the University of Birmingham and the Fetal Medicine Center, Birmingham Women's and Children's NHS Foundation Trust, Birmingham (M.D.K.), and University College London Hospitals NHS Foundation Trust, London (P.P.) - all in the United Kingdom; the Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Columbia University Irving Medical Center (R.S.M.), the Department of Pediatrics, Division of Hematology-Oncology, Weill Cornell Medical College (J.B.B.), and NewYork-Presbyterian Hospital (J.B.B.) - all in New York; the Department of Obstetrics and Gynecology, University Hospitals KU Leuven, Leuven, and the Department of Obstetrics, Gynecology, and Fertility, GZA Campus Sint-Augustinus, Wilrijk - both in Belgium (R.D.); Centre Hospitalier Universitaire Sainte-Justine Research Center, Université de Montréal, Montreal (F.A.), and Mount Sinai Hospital Toronto and University of Toronto, Toronto (R.W.) - both in Canada; UPMC Magee-Womens Hospital, Pittsburgh (S.P.E.); the Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Cincinnati Medical Center, Cincinnati (K.M.); the Department of Obstetrics and Gynecology, University of California, San Francisco, and Zuckerberg San Francisco General Hospital - both in San Francisco (M.E.N.); San Cecilio University Hospital, Granada, Spain (O.O.-H.); the Department of Obstetrics and Gynecology, Oregon Health and Science University, Portland (L.P.); University of Utah Health, Salt Lake City (R.M.S.); and Streisand Biomedical Consulting, Wayland, MA (J.B.S.).

Background: In early-onset severe hemolytic disease of the fetus and newborn (HDFN), transplacental transfer of maternal antierythrocyte IgG alloantibodies causes fetal anemia that leads to the use of high-risk intrauterine transfusions in order to avoid fetal hydrops and fetal death. Nipocalimab, an anti-neonatal Fc receptor blocker, inhibits transplacental IgG transfer and lowers maternal IgG levels.

Methods: In an international, open-label, single-group, phase 2 study, we assessed treatment with intravenous nipocalimab (30 or 45 mg per kilogram of body weight per week) administered from 14 to 35 weeks' gestation in participants with pregnancies at high risk for recurrent early-onset severe HDFN.

View Article and Find Full Text PDF

Nonimmune Hydrops Fetalis.

Neoreviews

August 2024

Department of Women's Health, Navy Medicine Readiness and Training Command Portsmouth, Portsmouth, VA.

Nonimmune hydrops fetalis (NIHF) poses a significant challenge in perinatal care due to its high mortality rates and diverse etiologies. This comprehensive review examines the pathophysiology, etiology, antenatal diagnosis and management, postnatal care, and outcomes of NIHF. NIHF arises from numerous underlying pathologies, including genetic disorders, cardiovascular causes, and fetal infections, with advances in diagnostic techniques improving identification rates.

View Article and Find Full Text PDF

Want AI Summaries of new PubMed Abstracts delivered to your In-box?

Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!