Module information
Module details
- Title
- Pregnancy and Screening
- Type
- Specialist
- Module code
- S-CB-S4
- Credits
- 10
- Phase
- 3
- Requirement
- Compulsory
Aim of this module
This module will provide the trainee with the knowledge to understand the physiology associated with normal pregnancy. They will be able to interpret biochemical data to identify and gain experience in the diagnosis of pregnancy associated complications including pre-eclampsia, HELLP, gestational diabetes, obstetric cholestasis, thyroid dysfunction and ectopic pregnancies.
The module will provide trainees with an understanding of the principles of screening and the rationale for antenatal and newborn screening programmes. The trainee will gain experience in the interpretation of screening results and be able to apply the terms sensitivity, specificity, screen positive rate (SPR), false positive rate (FPR) and multiple of the median (MoM) appropriately.
Work-based content
Training activities
| # | Learning outcome | Training activity | Type | Action |
|---|---|---|---|---|
| # 1 | Learning outcome 2 |
Training activities
Perform the analyses involved in the detection of pregnancy to laboratory standard operating procedures To include:
|
Type ETA | Action View |
| # 2 | Learning outcome 1,3 |
Training activities
Interpret and report routine biochemical results in the pregnant population identifying cases where pregnancy specific reference ranges have been used. To include two of the following:
|
Type ETA | Action View |
| # 3 | Learning outcome 3 |
Training activities
Perform the analyses involved in the detection of pregnancy specific complications to laboratory standard operating procedures to include three of the following:
|
Type ETA | Action View |
| # 4 | Learning outcome 3 |
Training activities
Identify cases that require urgent intervention and offer clinical advice on the follow-up and further management for three of the following situations:
|
Type ETA | Action View |
| # 5 | Learning outcome 6 |
Training activities
Perform the analyses involved in the trisomy screening service including:
|
Type DTA | Action View |
| # 6 | Learning outcome 6 |
Training activities
Interpret the results of a trisomy screens to include:
|
Type DTA | Action View |
| # 7 | Learning outcome 4,5,6 |
Training activities
Interpret the results of a trisomy EQA report |
Type DTA | Action View |
| # 8 | Learning outcome 5,7 |
Training activities
Interpret and report the results of newborn screens, including examples of both negative and positive cases for three of the following conditions:
|
Type DTA | Action View |
| # 9 | Learning outcome 7, 3 |
Training activities
Assist with the performance, sample collection, analysis and interpretation of a sweat test |
Type DTA | Action View |
| # 10 | Learning outcome 4,5 |
Training activities
Perform vertical audit of a new born screening sample |
Type DTA | Action View |
Assessments
Complete 2 Case-Based Discussions
Complete 2 DOPS or OCEs
Direct Observation of Practical Skills Titles
- Interpret the results of antenatal oral glucose tolerance tests.
- Perform analyser maintenance for a platform involved in newborn screening or antenatal screening assays.
- Interpret an EQA report for analytes involved in the detection of pregnancy, and pregnancy associated complications of trisomy screening.
- Interpret the biochemical results for a pregnant woman using appropriate pregnancy specific reference ranges and take any appropriate necessary action.
Observed Clinical Event Titles
- Complete a tutorial for BMS staff detailing the trisomy and/or newborn screening programmes.
- Present a pregnancy complication case at a departmental/Duty Biochemist meeting.
- Perform a sweat test.
Learning outcomes
| # | Learning outcome |
|---|---|
| 1 | Describe the physiological differences associated with pregnancy. |
| 2 | Analyse biological samples using biochemical assays involved in the detection of pregnancy and apply scientific knowledge to evaluate assay results. |
| 3 | Interpret biochemical data accurately to identify the complications of pregnancy. |
| 4 | Explain the principles of a screening programme and apply the relevant terminology associated. |
| 5 | Evaluate the methodology and rationale of national screening programmes and explain the national standards associated with the trisomy and newborn screening programmes. |
| 6 | Analyse samples for trisomy screening and apply the appropriate methodology to calculate trisomy screening risks. |
| 7 | Discuss the psychosocial impact of testing in the antenatal and newborn screening programmes. |
Clinical experiences
Clinical experiences help you to develop insight into your practice and a greater understanding of your specialty's impact on patient care. Clinical experiences should be included in your training plan and you may be asked to help organise your experiences. Reflections and observations from your experiences may help you to advance your practice and can be used to develop evidence to demonstrate your awareness and appreciation of your specialty.
Activities
- Attend a local antenatal quality meeting. This could include an antenatal specific meeting, commissioner meeting or user meeting.
- Attend a local antenatal clinic to appreciate the patient experience of their care.
- Shadow the screening duty biochemist to appreciate their role.
- Visit a newborn screening laboratory.
Academic content (MSc in Clinical Science)
Important information
The academic parts of this module will be detailed and communicated to you by your university. Please contact them if you have questions regarding this module and its assessments. The module titles in your MSc may not be exactly identical to the work-based modules shown in the e-portfolio. Your modules will be aligned, however, to ensure that your academic and work-based learning are complimentary.
Learning outcomes
On successful completion of this module the trainee will be able to:
- Describe the non-pathological changes in physiology and biochemistry during pregnancy and the need for specific reference intervals.
- Evaluate the clinical use of biochemical parameters in pregnancy and the interpretation of results in a range of conditions affecting mother and/or fetus.
- Critically evaluate the design, operation and performance of biochemical and molecular techniques used in pregnancy and paediatric biochemistry.
- Apply integrative knowledge of screening programmes and the associated terminology.
- Demonstrate a critical awareness of the national screening programmes and the national standards associated specifically with the trisomy and newborn screening programmes.
- Demonstrate a critical awareness of the assays associated with trisomy screening and be aware of the methodology used to calculate trisomy screening risks.
- Discuss the national newborn screening programmes, including the conditions and assays used and the screening pathways associated with each condition.
Indicative content
- Criteria for, and statistical assessment of, screening programmes g. sensitivity, specificity, screen positive rate (SPR), false positive rate (FPR), and multiple of the median (MoM).
- Normal maternal and fetal physiology in pregnancy.
- Implications of pregnancy on common biochemical reference intervals.
- Monitoring of at-risk pregnant patients with diabetes mellitus, thyroid disease, liver disease, and renal disease.
- Diagnostic testing and monitoring of common complications of pregnancy (gestational diabetes, pre-eclampsia, HELLP syndrome, and obstetric cholestasis).
- Biochemical antenatal screening test protocol and methodology for Down’s syndrome, neural tube defects and other fetal malformations.
- Clinical conditions associated with newborn screening programmes, biochemical screening testing protocols and methodology.
- Confirmatory testing for antenatal and newborn screening programmes.
- Future directions in screening.