Question to the Department of Health and Social Care:

To ask His Majesty's Government what assessment the UK National Screening Committee has made of international approaches to antenatal screening for vasa praevia.

The UK National Screening Committee has undertaken several reviews of the evidence on screening for vasa praevia (VP), with the latest in 2023. These have included international evidence. The committee has also undertaken, and published, a modelling exercise to explore the way in which the findings from international evidence might play out in the United Kingdom’s population, titled The impact of ultrasound-based antenatal screening strategies to detect vasa praevia in the United Kingdom: An exploratory study using decision analytic modelling methods. This concluded that testing for VP in one of the known risk groups might help reduce VP in the UK while providing an opportunity to find out more about the condition.

The UK NSC has not previously considered the ethical implications of requiring randomised controlled trial (RCT) evidence for VP, as it has not insisted on this level of evidence. Even in the absence of screening, VP is a rare outcome.

The committee recognises the challenges of generating robust evidence in the context of rare conditions, for example, the criterion relating to RCT evidence is not applied rigidly in evaluations of rare diseases. Nevertheless, the committee requires an appropriate level of evidence to be confident that a screening programme would deliver more benefit than harm.

The committee remains open to ongoing dialogue with researchers and clinicians on how best to strengthen the evidence base and improve understanding of this condition.