A study carried out by Elizabeth Dormandy and colleagues from the SHIFT research team for the British Journal of General Practice has found that, despite early confirmation of pregnancy, 95% of women in the study did not receive antenatal screening for sickle cell and thalassaemia by the target time of 10 weeks.
Investigating the performance of 25 general practices in two inner city primary care trusts already offering universal screening, the study showed an average seven week delay between pregnancy confirmation in a primary care setting and antenatal screening for sickle cell and thalassaemia. Nearly three quarters of women confirmed pregnancy before 10 weeks' gestation, but fewer than 5% were tested by 10 weeks.
Dr Elizabeth Dormandy National Monitoring and Performance Manager for the NHS Sickle Cell and Thalassaemia Screening Programme and author of the study, comments: "These results show that the NHS has not yet got to grips with a new generation of genetic tests, our systems are lagging behind the new technologies. The point of antenatal screening for sickle cell and thalassaemia is to give parents information about whether their unborn baby is at risk of inheriting a serious disease. In this case the timing of the initial blood test is critical and delay undermines the ability to offer genuine informed choice."
Dr Allison Streetly, Director of the NHS Sickle Cell and Thalassaemia Screening Programme adds: "It is encouraging that so many women are accessing services early in their pregnancy as we would want. The urgent need now is to develop the dialogue between primary and maternity care services to ensure that we effectively capitalise on early access. That means either providing screening in a primary care setting or minimising the delay between primary care and seeing a midwife
"The Programme is already working to foster this debate and also to raise awareness that people can be screened at any time. So, for example, if young people are screened before they plan a family, they can explore their options without the pressure of a developing pregnancy."
The targets set out by the NHS Sickle Cell and Thalassaemia Screening Programme specify that an initial blood test should be provided before 10 weeks of pregnancy. This timing is determined by the screening timeline which potentially needs to allow for:
Dr Streetly concludes: "NICE is currently updating its guidelines on antenatal care. Due for publication in March 2008, we are hopeful that the new guidance will explicitly back our recommendations for early screening for sickle cell and thalassaemia and provide clear guidance on how sickle cell and thalassaemia screening fits into antenatal care as a whole."
Your comments: (Terms and conditions apply)
"I was not aware that Sickle Cell Disease and Thalassaemia was a UK genetic disease, however this should only be applied to certain immigrant populations who come here to live" - Gordon Smith, Bothwell, Scotland
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