The Committee on Practice Bulletins–Obstetrics of the American College of Obstetricians and Gynecologists (ACOG) has released a practice bulletin on screening for and managing hemoglobinopathies during pregnancy. Practice Bulletin Number 64, “Hemoglobinopathies in Pregnancy,” was published in the July 2005 issue of Obstetrics & Gynecology.
The ACOG recommendations, which are based on good, consistent evidence, include the following:
Persons of African, Southeast Asian, and Mediterranean descent are at increased risk of carrying hemoglobinopathies and should be offered screening and genetic counseling. Figure 1 is an algorithm for the antepartum evaluation for hematologic assessment of persons from high-risk groups.
Appropriate hemoglobinopathy screening should include a complete blood count and hemoglobin electrophoresis. Solubility tests alone should not be used as screening tools.
Parents at high risk of having a child with sickle cell disease or thalassemia should be offered genetic counseling, and a prenatal diagnosis should be obtained through DNA analysis of cultured amniocytes or chorionic villi.