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The present system of antenatal screening for carriers of haemoglobin
disorders means that many couples at risk of conceiving a child with a
sickle cell disorder or thalassaemia are identified too late for
prenatal diagnosis. Modell et al (p 788) investigated the feasibility
of improving screening for haemoglobin disorders in London general
practices by using a nurse facilitator. The number of requests from the
intervention practices almost doubled in the study year; over half the
increase was due to singlehanded practitioners working in areas with a
high proportion of ethnic minority residents. The authors conclude that
carrier screening in primary care is already happening and can be
increased but needs to be coupled with early antenatal testing.
Israeli students are refusing to perform intimate examinations on anaesthetised women without their informed consent.