Purpose of the FOQ
The FOQ is a mandatory tool used during antenatal booking to identify individuals at risk of being carriers for sickle cell, thalassaemia, or other haemoglobin variants. It informs whether further blood testing is required and helps interpret results accurately.
Step-by-step guidance for midwives
1. Timing
- Complete the FOQ at the booking appointment, ideally by 10+0 weeks gestation.
- If the woman presents later in pregnancy, still offer screening.
2. Who completes it
- The midwife should complete the FOQ with the woman, ensuring clarity and accuracy.
- Include information about the baby’s biological father where possible.
3. How to complete
- Tick all relevant boxes for both the woman and the baby’s father.
- Consider at least three generations when assessing family origin.
- Do not confuse ethnicity with nationality—focus on ancestral origin.
4. Information to include
- Gestational age (in weeks and days) and Estimated Due Date (EDD).
- Clear and legible requestor’s signature.
- Ensure the FOQ is fully completed and attached to the blood sample request.
5. Blood sample
- Send a lavender-top tube (FBC) to the laboratory same day as venesection.
- Label the sample as antenatal screening and place it in a clear specimen bag with the FOQ.
6. If FOQ is incomplete
- The lab will contact the Screening Coordinator.
- The midwife must respond promptly with a new sample and request to be sent.
Key Screening Notes
- High-risk origins (e.g. West African, Mediterranean, Middle Eastern, South Asian) may trigger additional testing.
- Low-risk women may not be tested for sickle cell unless red cell indices suggest thalassaemia.
- Repeat testing is required in every pregnancy, even if previously screened
Discuss with the Woman
- Explain the benefits of screening and implications of a positive result.
- Discuss recessive inheritance and the possibility of being a carrier.
- Provide access to the digital leaflet: “Screening Tests for You and Your Baby”.