Background Information

In 1993 it was recommended that there should be universal screening for haemoglobinopathies in areas where the ethnic population of pregnant women is over 15% and that specialist counselling should be available (SMAC, 1993). In the UK there are approximately 8000-10000 people living with sickle cell disease (Oni, 1998) and approximately 600 people with thalassaemia major (Davies et al, 2000).

Haemoglobinopathies are, therefore, a major health problem in this country. It is important that antenatal women and their husband\partner are given information regarding the inheritance, prevention, and management of these conditions. Antenatal screening provides the couple with an opportunity to find out, early in pregnancy, whether or not they are at risk of having a child with a major haemoglobinopathy. With early detection of 'at risk' couples, prenatal diagnosis can be offered, giving them the chance to find out if the baby is affected. They can then choose to continue, or terminate, the pregnancy

Counselling Procedure

The Brent Sickle Cell & Thalassaemia centre is part of the North West London Hospital NHS Trust and it offers universal haemoglobinopathy screening to all women booked for confinement at Central Middlesex Hospital and Northwick Park Hospital.

The midwife does the haemoglobinopathy test routinely at the first antenatal booking session. If a woman is found to have inherited an unusual haemoglobin type, she would be informed and invited for genetic counselling and testing of her husband/partner.