Referral criteria
| Category A | Category B | Category C |
|---|---|---|
| Local hospital planned care, refer to MDT for opinion if required | Consider referral to MDT for discussion and advice | Refer to MDT – Consider transfer of care |
| Haemoglobinopathy | Refer to Haemoglobinopathy Treating Centre | |
| • Sickle cell trait | • Sickle cell disease |
|
| • Alpha thalassaemia carriers • Beta thalassaemia carriers, not requiring transfusions | • Non transfusion-dependent thalassaemia such as HbH or thalassaemia intermedia | • Beta thalassaemia major • Transfusion dependent thalassaemia (including intermedia requiring transfusions during pregnancy) |
| • Uncomplicated enzyme or membrane disorders without iron overload | • Rare inherited anaemias | |
| Bleeding Disorders | Bleeding Disorders | Refer to Haemophilia Comprehensive Care Centre (HCC) |
| • Haemophilia carrier with normal levels and female fetus | • Low-level haemophilia carrier • All carriers of severe haemophilia A or B |
|
| • Carriers of haemophilia with a male fetus (or gender unknown) | ||
| • Type 1 VWD | • Type 2 and 3 VWD | |
| • Other mild bleeding disorders | • FXI deficiency with bleeding phenotype | |
| • Any other severe bleeding disorder eg Glanzmann’s, Bernard Soulier | ||
| Malignancy, MPN, other Haematological disorders | ||
| • Previous haem malignancy in remission without late effects | • Previous haem malignancy with late effects or post bone marrow transplant | • Active haem malignancy |
| • Haematinic deficiencies and iron deficiency anaemia | • Autoimmune hemolytic anaemia (AIHA) | • Aplastic anaemia • Paroxysmal nocturnal haemoglobinuria (PNH) • Myeloproliferative conditions (ET/PV/MF) |
| Mechanical Heart Valves | ||
| • All mechanical heart valves | ||
| VTE | ||
| • VTE in previous pregnancy High risk VTE (RCOG guidelines RA) | • Acute VTE in current pregnancy at <32 weeks gestation | • Acute VTE at >32 weeks gestation • Complex VTE |
| • Inherited thrombophilia (except antithrombin deficiency) | • Antithrombin deficiency | |
| • Obstetric antiphospholipid syndrome | • Thrombotic antiphospholipid syndrome | |
| Thrombocytopenia | ||
| • Gestational thrombocytopenia • All other ITP | • ITP requiring treatment in pregnancy (previous or current) • ITP with previous neonatal thrombocytopenia or bleeding | • Complicated ITP or platelet count consistently <50 |
| • Women with history of TTP or atypical HUS | ||
| Antibody Mediated Conditions | ||
| • Low risk red cell antibodies | • Previous NAIT • HDFN requiring IVIG antenatally |
Make or Retrieve a Referral
East Midlands Obstetric Haematology Leads
| Haematologist | Obstetrician | Midwife | Specialist Nurse | |
|---|---|---|---|---|
| UHL | Amy Webster Bethan Myers | Helena Maybury | Sarah Evans | Saija Hayes |
| NUH | Gill Swallow | Jo Webb | ||
| UHDB | Angela McKernan Haris Kartsios | Rosie Hamilton | Alison Brewer | |
| CRH | ||||
| SFHFT | Jyothi Rajeswary Anupriya Annapurni Susanna Al-Samarrai | |||
| ULH | Kavita Agarwal | |||
| NGH | Jane Parker Alistair Mcgrann Angela Bowen Mike Joffe | Sue Lloyd Kate Jones | ||
| KGH | Karyn Longmuir | Karen Austin Smith | Sarah Barnes |
MDT chairs
Helena Maybury Obstetrician
UHL
Gill Swallow – Haematologist
NUH