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Hematology

Hemoglobin electrophoresis and planning a pregnancy: thalassaemia and sickle cell carriership

Haemoglobin is in the red blood cells and, according to the NVKC, carries oxygen from the lungs to the organs. According to the NVKC, a disorder in the shape and function of haemoglobin, a haemoglobinopathy, is hereditary: a child can inherit the disease from the mother, the father or both.

According to the NVKC, a carrier usually has no symptoms, but if both parents are carriers, the children can get the disease, with a 25% chance. Only a blood test can show whether someone is a carrier.

Certe uses 2 - 3.2 % for HbA2 and 96 - 98 % for HbA.

Doctor's Assessment Included

Hemoglobin electrophoresis measures the share of HbA, HbA2, HbF and abnormal forms such as Hb-S. According to the NVKC, the test detects inherited disorders of haemoglobin, such as thalassaemia and sickle cell disease.

  • Star-SHL uses 2.2 - 3.2 % for HbA2, Certe 2 - 3.2 % and Unilabs 2.2 - 3.2 %.
  • According to the NVKC, a raised HbA2 characterises a beta-thalassaemia.
  • According to the NVKC, if both parents carry a haemoglobinopathy, the children can get the disease, with a 25% chance.

Reference Ranges

No established reference range

A haemoglobin electrophoresis does not produce a single number but a pattern of fractions (HbA, HbA2, HbF and any variants such as HbS or HbC). One reference interval for the test as a whole cannot be interpreted: a clinically important raised HbA2 — the marker of beta-thalassaemia carriership — would be wrongly reported as "low". The result is assessed per fraction.

Reference ranges may vary between laboratories. When you order a test, a BIG-registered doctor assesses your personal results in context. For treatment decisions, discuss your results with your GP.

Hemoglobin Electrophoresis: what this test measures

Hemoglobin electrophoresis measures the ratio between HbA, HbA2, HbF and abnormal forms such as Hb-S in percent; Certe calls the panel HbP-onderzoek.

Hemoglobin Electrophoresis: why this value matters

Hemoglobin electrophoresis matters when planning a pregnancy because, according to Erfelijkheid.nl, carriers of beta-thalassaemia have no or few features, while a child of two carriers can get beta-thalassaemia.

Hemoglobin Electrophoresis: how the blood test works

Referral
No GP referral needed. After the order we arrange the referral through ZorgDomein, within one business day; orders after 17:00 or at the weekend start on the next business day. ZorgDomein emails a barcode, and that barcode is what the draw site needs.
The draw
A blood draw from a vein in the arm, at a partner laboratory's draw site. No home kit, no finger prick.
Where
650+ draw sites run by independent laboratories across the Netherlands. Draw sites

Hemoglobin Electrophoresis: when is testing worthwhile?

According to the NVKC, a haemoglobinopathy test can be done before birth at the parents' request, and also when a couple is not yet pregnant; then both the man and the woman are tested.

Hemoglobin Electrophoresis: symptoms of a high or low value

Low Levels

According to the NVKC, sickle cell carriership is characterised by a lowered HbA of 45 to 55% and 35 to 45% Hb-S; Certe uses 96 - 98 % for HbA.

High Levels

Certe uses 2 - 3.2 % for HbA2, and according to the NVKC a raised percentage of HbA2 characterises a beta-thalassaemia; for a baby younger than 16 days Certe uses 60 - 90 % for HbF.

Hemoglobin Electrophoresis: causes of a low or high value

What lowers the value

  • Sickle cell carriership (HbA)

    Sickle cell carriership is characterised by a lowered percentage of HbA, 45 to 55%, and in sickle cell disease HbA is absent.

  • Alpha-thalassaemia (HbA2)

    An alpha-thalassaemia is characterised by a normal to lowered HbA2, a raised number of red blood cells and a low MCV.

  • Iron deficiency alongside a beta-thalassaemia (HbA2)

    If there is iron deficiency or another haemoglobinopathy alongside a beta-thalassaemia, HbA2 need not be raised.

What raises the value

  • Beta-thalassaemia carriership or disease (HbA2)

    A beta-thalassaemia is characterised by a raised percentage of HbA2, a raised number of red blood cells and a low MCV.

  • Sickle cell carriership or disease (Hb-S)

    In sickle cell carriership 35 to 45% Hb-S is present, in sickle cell disease more than 50%.

  • Age under one year (HbF)

    In children HbF is high shortly after birth; after a year all HbF should have disappeared.

Hemoglobin Electrophoresis: lifestyle and this value

Discuss an abnormal hemoglobin electrophoresis with your GP when planning a pregnancy; according to Erfelijkheid.nl, the doctor can refer you to a clinical geneticist if needed.

Hemoglobin Electrophoresis: frequently asked questions

Is a baby tested for sickle cell disease and thalassaemia?

Yes, according to the NVKC haemoglobin variants are tested in the heel prick shortly after birth, for sickle cell anaemia, beta-thalassaemia and alpha-thalassaemia.

Hemoglobin Electrophoresis: sources

  1. NVKC, Alles over testen: Hemoglobinopathie, allesovertesten.nl, geraadpleegd 2026-10-19 (retrieved 2026) allesovertesten.nl

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