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KCE reports vol. 6A Prenatale zorg 74
Risk recognition pregnancy
Risk recognised in 27/63 (43%)
pregnancies before 1990 and in 41/74
(55%) pregnancies after 1990
7What tests are available for detecting maternal haemoglobinopathies?
Study Ref Populatio Interventio Outcomes Results Comment Study EL
n n
s type
Zeuner et al., 4 [279] N/A Screening and 1. Estimation of red blood cell indices. MCH < 27 pg indicates p. 5, 8-10 HTA RW
1999
diagnosis algorithm thalassaemia trait
4
2. Subsequent quantification of HbA and HbF for thalassaemia
trait (via HPLC) and identification of Hb structural
variants for sickle cell traits (via isoelectric focusing)
3. If HbA and HbF > 3.5% is indicative
of thalassaemia trait
4. Partner testing initiated
5. DNA analysis used when assessment of at-risk pregnancy
cannot be adequately obtained by phenotyping
Do effective interventions exist to improve outcomes for these women?
Study Ref Population Intervention Outcomes Results Comments Study
Modell et
al.,1997
4 [277] 2068 cases of prenatal
diagnosis in England
from 1974 to 1994
Comparison of prenatal diagnosis
for Hb disorders with annual
number of pregnancies at risk for
these disorders (ethnic group data
from 1991 census)
Utilisation of
prenatal
diagnosis
Termination of
pregnancy
Utilisation for thalassaemias: 55%
(range 10% among Bangladeshis
to 89% among Cypriots)
Use for sickle cell disorders: 13%
by black Africans and black
EL
type
CSS 3