| Category A Local Expertise | Category B Clinical review, advice and guidance from MMC | Category C Care led by MMC (UCLH unless stated otherwise) |
|---|---|---|
| Historical immune thrombocytopenia and platelet count >75 | Current immune thrombocytopenia and platelet count ≤75 | Sickle cell disease (deliver at Whittington/UCLH/NMUH) |
| Gestational thrombocytopenia | Thrombocytosis | Beta thalassaemia major (deliver at Whittington/UCLH/NMUH) |
| Current VTE or previous single VTE | Mild, isolated clotting factor deficiency | Transfusion dependent disease (Whit/UCLH) |
| Obstetric antiphospholipid syndrome | Mild platelet function disorder | Other complex thalassaemia (Whit/UCLH): - Iron overload - Endocrine disease - Pulmonary hypertension |
| Inherited thrombophilia (no VTE, not antithrombin deficiency) | Thrombotic antiphospholipid syndrome | Current extensive VTE (UCLH) |
| History of treated haematological Malignancy | Inherited thrombophilia with previous VTE | Antiphospholipid syndrome with extensive arterial events or requiring regular anti Xa monitoring (UCLH) |
| B12/folate deficiency | Recurrent VTE | Antithrombin deficiency (UCLH) |
| Carriers of haemophilia with known female fetus and normal factor VIII/IX | Active haematological malignancy (UCLH) | |
| Type I Von-Willebrand disease, VWF activity normalised in pregnancy | Moderate – severe clotting factor deficiency (UCLH) | |
| Stable myeloproliferative/myelodysplastic Disease | Moderate/severe platelet function disorder or platelet disorder with platelet count (UCLH) | |
| White cell disorders | Carriers of haemophilia with male or unknown gender of fetus (UCLH) |
|
| Von-Willebrand disease: Type 1 if VWF not normalised, Type II and Type III (UCLH) |
Resources:
- Guidelines for the Management of SCD in pregnancy
- British Society of Haematology Guidelines
- Royal College of Obstetric & Gynaecology
- Red cell network guidelines