Back Module: S-HT-S3

Transfusion – Antenatal Serology

Module information

Module details

Title
Transfusion – Antenatal Serology
Type
Specialist
Module code
S-HT-S3
Credits
10
Phase
3
Requirement
Optional

Aim of this module

This module will provide the trainees with knowledge and experience in performing antenatal testing, interpretation and referral in accordance with current guidelines.

Work-based content

Training activities

# Learning outcome Training activity Type Action
# 1 Learning outcome 1,2 Training activities

Perform sample identification and acceptance according to current guidelines and laboratory policies

 Type ETA Action View
# 2 Learning outcome 1,2,3,4,5 Training activities

Perform investigation and interpret results for pregnancies at risk of HDFN

 Type ETA Action View
# 3 Learning outcome 1,2,3,4,5,6 Training activities

Identify samples requiring maternal/paternal/fetal typing and recommend appropriate referral

 Type ETA Action View
# 4 Learning outcome 1,2,3,4,5,6,7 Training activities

Identify clinically significant antibodies and determine antibody concentration by:

  • Titration
  • Quantification
 Type DTA Action View
# 5 Learning outcome 1,3,4,5,6,7,8 Training activities

Provide advice on the appropriate use of anti-D in prevention of HDFN

 Type DTA Action View
# 6 Learning outcome 1,2,3,4,5,6,7,8 Training activities

Perform and interpret results and suggest follow-up testing and clinical management of the patient for feto-maternal haemorrhage (FMH) monitoring

 Type DTA Action View
# 7 Learning outcome 1,3,4,5,6,7 Training activities

Identify pregnancies requiring obstetrician or FMU referral according to guidelines

 Type ETA Action View
# 8 Learning outcome 1,5,6,7,8,9 Training activities

Develop a management plan including selection of appropriate blood components for:

  • Mother
    • Pre-delivery
    • Post-delivery
  • Fetus
  • Neonate
 Type ETA Action View
# 9 Learning outcome 1,6,7,9 Training activities

Apply patient blood management principles to optimise care of patients who may require a blood transfusion during pregnancy

 Type DTA Action View
# 10 Learning outcome 1,6,7,8,9 Training activities

Identify the steps required to manage a case involving major obstetric haemorrhage, including:

  • Supply of appropriate units including management of timelines
  • Identify healthcare professional involved the patient care
 Type ETA Action View

Assessments

Complete 2 Case-Based Discussions

Complete 2 DOPS or OCEs

Direct Observation of Practical Skills Titles

  • Perform quantification/titre of maternal antibodies.
  • Perform and interpret a Kleihauer test and describe appropriate dosing of anti D.
  • Select the blood component(s) for an IUT.
  • Select the blood component(s) for transfusion during pregnancy.

Observed Clinical Event Titles

  • Discuss clinically significant antibody results with an obstetrician/midwife.
  • Discuss FMH results with an obstetrician/midwife.
  • Provide advice on the appropriate dose of anti D.
  • Obtain a patient history from a healthcare professional involved in a patient’s care.

Learning outcomes

# Learning outcome
1

Practice in accordance with antenatal serology standards and guidelines.
2

Perform acceptance testing of samples requiring antenatal investigation.
3

Perform and interpret clinical and laboratory investigations to identify cases of haemolytic disease of the fetus or newborn (HDFN).
4

Identify sequential testing algorithms appropriate to the samples under investigation for HDFN.
5

Predict current and future pregnancies at highest risk of HDFN.
6

Identify and advise healthcare professionals on appropriate actions to manage HDFN.
7

Develop management plans including selection of blood components for mother, fetus and neonates during pregnancy.
8

Identify actions required in cases of potentially sensitising events during pregnancy.
9

Apply patient blood management principles during pregnancy.

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

  1. Attend an anti D clinic.
  2. Attend a fetal medicine unit clinic.
  3. Observe a doppler scan.

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:

  1. Explain the importance of optimising haematological indices during pregnancy.
  2. Examine the aetiology and pathogenesis of HDFN including the factors that determine the clinical relevance of an antibody and the importance of antibody quantification in pregnancies at risk of HDFN.
  3. Critically evaluate the tests performed in the investigation of FMH.
  4. Discuss and justify the current guidelines for the use of anti-D prophylaxis.
  5. Critically appraise the requirements for blood component selection for maternal/ fetal/ neonatal transfusion.

Indicative content

  • Changes in haematological indices in normal pregnancy.
  • Managing haematological disorders during pregnancy.
  • Haematinics.
  • HDFN
  • Tests involved in the investigation of FMH and sensititsation – Kleihauer-Betke, flow cytometry, direct antiglobulin test (DAT) and indirect antiglobulin test (IAT).
  • Tests involved in the investigation of HDFN – MCA doppler scan, ultrasound, amniocentesis and antibody quantification.
  • Maternal, paternal and fetal phenotyping.
  • cffDNA testing.
  • Current guidelines surrounding anti-D prophylaxis administration.
  • Special blood requirements for pregnancies.
  • IUTs.
  • Exchange and top-up transfusions.
  • Major obstetric haemorrhage – current guidelines and use of alternatives to standard blood products.

Module assigned to

Specialties

Specialty code Specialty title Action
Specialty code SLS1-2-22 Specialty title Haematology & Transfusion Science [2022] Action View
Specialty code SLS1-2-23 Specialty title Haematology & Transfusion Science [2023] Action View
Specialty code SLS1-2-24 Specialty title Haematology & Transfusion Science [2024] Action View
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