Referral criteria
For women requiring MMC led care they are often managed in the specialist Obstetric Haematology clinic on Monday afternoon’s at the RVI
Lead Maternal Medicine Obstetrician- Dr T Shears
Lead Haematologist- Dr S Kazi
Haematology
Clinical resources
British Society of Haematology- Guidelines for the management of sickle cell disease in pregnancy Guidelines for the Management of sickle cell disease in pregnancy
British Society of Haematology- Guideline for the management of conception and pregnancy in thalassaemia syndromes Guideline for the Management of Conception and Pregnancy in Thalassaemia Syndromes
British Society of Haematology- UK guidelines on the management of iron deficiency in pregnancy UK guidelines on the management of iron deficiency in pregnancy
RCOG Green top guideline- Management of sickle cell disease in pregnancy
Patient information
The Haemophilia Society- Haemophilia- Pregnancy and Childbirth Haemophilia – Pregnancy and Childbirth | The Haemophilia Society
World federation of Haemophilia- Women and girls with Haemophilia pdf-2342.pdf
| Category A Local expertise | Category B Review, advice and guidance from maternal medicine centre | Category C Care led by maternal medicine centre |
|---|---|---|
| Sickle cell trait | Current immune thrombocytopenia and platelet count ≤ | Sickle cell disease |
| Historical immune thrombocytopenia and platelet count >75 | Thrombocytosis | Beta thalassaemia major |
| Gestational thrombocytopenia | White cell disorders | Complex thalassaemia Iron overload Endocrine disease Pulmonary hypertension |
| Current VTE or previous single VTE | Recurrent VTE | Current extensive VTE without other access to Factor Xa monitoring |
| Obstetric antiphospholipid syndrome | Thrombotic antiphospholipid syndrome | Antiphospholipid syndrome with extensive arterial events |
| Inherited thrombophilia (no VTE, not antithrombin deficiency) | Inherited thrombophilia with prvious VTE | Antithrombin deficiency |
| History of treated haematological malignancy | Stable myeloproliferative/myelodysplastic disease | Active haematological malignancy |
| Alpha/beta thalassaemia trait | Mild, isolated clotting factor deficiency Factor II, V, XI or XIII>0.2iu/ml Factor X > 0.3iu/ml | Clotting factor deficiency Factor II, V,XI or XIII≤0.2iu/ml Factor X ≤0.3iu/ml Combined deficiencies |
| B12/Folate deficiency | Mild platelet function disorder with platelet count >100 | Moderate/severe platelet function disorder or with platelet count >100 |
| Carriers of haemophilia with known female fetus and normal factor VIII/IX | Carriers of haemophillia with male or unknown gender of fetus | |
| Type I Von-Willebrand disease, VWF activity normalised in pregnancy | Von-Willebrand disease: Type 1 if VWF not normalised Type II and Type III | |
| Transfusion dependent disease |