This is a classical case involving a woman with a history of giving birth to a child with Hemolytic Disease of the Newborn (HDN). The client was in her eleventh week of her third pregnancy when she reported to our facility for antibody detection, identification and titration. Consequently, we detected two alloimmune antibodies capable of crossing the placenta barrier; IgG B and Rh “D” antibodies. The Rh “D” antibodies were in alarming and increasing states from week 11 to week 25 when the woman traveled out of jurisdiction. The IgG anti-B was in a relative stable quantity throughout the monitoring period. She was delivered on the 38th week of gestation and the baby was typed to be A Rh “D” Negative and was not carrying any of the antigens to the antibodies detected. We found this worth reporting because there was no fetal stimulus causing the rising levels of the Rh “D” antibody; we thus propose fetal microchimerism as the potential cause since the woman had a history of bearing children with the antigens to the antibodies detected. This is a phenomenon that has been postulated to be involved in the etiology of hemolytic disease of the newborn.

Chlamydia is the most common Sexually Transmitted Infection (STI) among young people aged 16-24 years old. The infection is largely asymptomatic and therefore regular screening is required to detect, treat and identify those at risk. If left untreated, chlamydia can result in serious long term consequences, particularly for women. These include pelvic inflammatory disease, ectopic pregnancy and infertility. Current levels of screening in the England cover only a small proportion of the eligible population. Technological advances offer the opportunity to redesign existing asymptomatic chlamydia screening/ testing and treatment pathways in England, leading to increased testing uptake, higher treatment rates and reduced disease transmission. Innovations underway include self-tests networked through mobile phones, combined with online clinical care and other non-face-to-face care pathways. Two levels of integration of technology into mainstream sexual health services are possible. The most ambitious is a fully remote online pathway incorporating a self-test, plus online treatment and partner notification. A less ambitious service would consist of postal home sampling kits with a partial remote online pathway for results notification, treatment provision and partner notification. In this article we discuss the current state of adoption of new technologies in the sexual health service delivery pathway within the overall context of digital technology use in England, the emergence of a national digital health policy, and challenges to the adoption of telemedicine and telehealth technologies. Consideration of these aspects should help technology developers, policy makers and service providers to optimize future technology adoption and service re-design in STI care or related clinical areas.