1. Croydon Health Services
ANTENATAL AND NEW BORN SCREENING
(ANNB)

2. SCREENING
It is a process of identifying apparently healthy people who may be at increased risk of a disease/ condition.
They can be offered information, further tests and appropriate treatment to reduce the risk and/or any complication arising from the disease or condition
Public Health England (PHE) leads the national screening programmes
The screening programmes are implemented on the advice of the UK National Screening Committee (UKNSC)

3. ANNB SCREENING PROGRAMMES
Six components:
Sickle Cell and Thalassemia (SCAT)
Infectious Diseases (ID)
Downs Syndrome Screening and Fetal Anomaly
Newborn Infant Physical Examination (NIPE)
Newborn Blood Spot (NBBS)
Newborn Hearing Screening

4. Sickle Cell and Thalassemia (SCAT)
Croydon is a high prevalence area
Booking bloods by 8-10 week
If screen positive:
Referred to SCAT centre for Genetic counselling and Haematology clinic
Prenatal Diagnosis (PND) – Done at Kings College Hospital.
Early referral/ Early booking/ Early intervention

5. INFECTIOUS DISEASES
Minimum 95% uptake of screening in pregnancy is required.
HIV
Hepatitis B
Syphilis

6. HIV
Number of HIV positive women looked after in pregnancy in 2015/16 were 17, 4 were newly diagnosed
Caseload Care by Infectious Disease team (ID)
- Lavender Team –Midwifery Team
- Heath Clinic – Sexual health Screening/ Viral Load monitoring
-Lead Obstetrician (for ID) – Mr Kamel
Early referral/ Early booking/ Early intervention

7. HEPATITIS B TEAM -Lavender team -Hepatologist – Dr Philipose
-Obstetric Consultant – Mr Kamel
2015/ Hepatitis B positive (CUH)
Patients are reviewed at 20/40 and 36/40 by the Obstetrician
Plan of care for delivery is made for birth and the baby in the postnatal period.
Baby’s care plan - which could include vaccine and/or immunoglobulin

8. SYPHILIS Syphilis can result in congenital syphilis (CS)
Untreated syphilis can result in a range of adverse outcomes, including:
-premature birth
-stillbirth
-congenital abnormalities
Screening is done at booking, results are followed by the ID team
Remember new infections can occur late in pregnancy
Antibiotics
Neonatal assessment at birth to look for signs of congenital syphilis

9. DOWNS SYNDROME SCREENING AND FETAL ANOMALY
Combined –First trimester (Local uptake-61%)
Quad- 2nd trimester (Local uptake -14%)
Declined screening =10.5%
Screen Positive
Non- Invasive Pre natal Test (NIPT)
CVS 34
Amniocentesis 21

10. Multidisciplinary team for anueploidy screening
Midwives – Mary O’Mahoney
Sonographers – Becky Paine
Obstetricians – Heather Allen-Coward, Rosol Hamid
Maternity support workers

11. Non- Invasive Pre natal Test (NIPT)
Placentally derived, cell free DNA extracted from maternal circulation
Screening for T13,T18 and T21
Offered to screen positive singleton pregnancies from weeks
99% sensitive
Results obtained in 5-7 days
Private

12. Fetal anomaly 18+0- 20+6 weeks Fetal anomaly screening Program (FASP)
FETAL ANOMALY SCAN
Fetal anomaly weeks
Fetal anomaly screening Program (FASP)
Anencephaly
Open spina bifida Exomphalos
Serious cardiac abnormalities Cleft lip
Diaphragmatic hernia Gastroschisis
Bilateral renal agenesis Lethal skeletal dysplasia
No of fetal anomaly scans 3126 (81%)
Pathway
Weekly perinatal meeting
9/26/20179/26/2017

13. Newborn Blood Spot (NBBS)
Conditions Screen :
- Sickle cell disease (SCD)
- Cystic Fibrosis (CF)
- Congenital Hypothyroidism (CHT)
- Phenylketonuria(PKU)
- Medium chain acyl-CoA dehydrogenase deficiency (MCADD)
-Maple Syrup disease (MSUD)
-Isovaleric acidemia (IVA)
-Glutaric aciduria type 1 (GA1)
-Hystocystinuria (HCU)
9/26/20179/26/2017

14. Newborn Infant Physical Examination (NIPE)
Screening lead – Dr Kumar, Mary O’Mahoney
Identifies congenital abnormalities of:
Heart
Hips
Eyes
Testes
NIPE clinic runs 7 days per week.
Undertaken by 72 hours of age and at 6-8 weeks by the GPs
9/26/20179/26/2017

15. NEWBORN HEARING SCREENING
All babies are offered hearing screen with 4 weeks of life
Performed in house prior to discharge
Outpatient within 1 month of birth
2015/2016
Unlateral hearing loss 8
Bilateral hearing loss 8
9/26/20179/26/2017

16. CONTACT DETAILS ANNB team/ Lavender Team 0208 401 3000 ex 4131/ 4004
SCAT Centre