| Category A Local Expertise | Category B Consider discussion with Maternal Medicine Centre (MMC) | Category C Care led by Maternal Medicine Centre |
|---|---|---|
| Sickle cell trait | Sickle cell disease | |
| Alpha/beta thalassaemia trait | Beta thalassaemia major | |
| Other complex thalassaemia: . • iron overload • Endocrine disease |
||
| Current VTE / previous single VTE | Recurrent VTE | Current VTE requiring anti Xa monitoring without same-day turnaround of result |
| Antiphospholipid syndrome with early pregnancy loss with no thrombotic history | Antiphospholipid syndrome with history of second or third trimester loss, with no thrombosis history | Antiphospholipid syndrome with any maternal arterial or venous thrombosis OR any evidence of active disease OR therapeutically anticoagulated when not pregnant |
| Inherited thrombophilia (no VTE, not antithrombin deficiency) | Inherited thrombophilia with previous VTE | Antithrombin deficiency |
| Gestational thrombocytopeni documented normal pit count in firs trimester) | Plt count 75-150 x109/L not gestational or related to a pregnancy-specific cause | Pits <75 x109/L with no acute/transienUpregnancy-specific cause identified AND no urgent local haematolooy review available |
| Mild platelet function disorder (e g storage pool disease, signalling or ADF eceptor defects) | Moderate/severe platelet function disorder (e.g. thrombasthenia, Benard Souis syndrome) |
|
| History of treated haematological malignancy | Stable myeloproliferative/myelodysplastic disease | Active haematological malignancy |
| B 12/folate deficiency | White cell disorders | Transfusion-dependent disease |
| Thrombocytosis (pits >450 x109/L on two occasions) without evidence of iron deficiency or other underlvina cause | ||
| Mild, isolated clotting factor deficiency • Factor II, V, VII, XI or XIII > 0.2iu/ml • Factor X > 0.3iu/ml| | Clotting factor deficiency: • Factor II, V, VII, XI or XIII ≤ 0.2iu/ml • Factor X ≤ 0.3iu/ml • Combined deficiencies |
|
| Carriers of haemophilia with known female fetus AND normal maternal factor VIII/IX levels | Cartiers of haemophila with male or unknown gender of fetus | |
| Type 1 Von-Willebrand disease/low VWF where VWF activity normalised in pregnancy | Von-Willebrand disease: Type 1 /low VWF if WWF not normalised, Type 2, Type 3, platelet-type VWD |
|
| Therapeutic anticoagulation when not pregnant for mechanical heart valve / APLS /VTE with antithrombin deficiency |
||
| Previous or current TTP/HUS |
