A tale of two sisters: Successful pregnancies in two sisters with transfusion-dependent thalassemia (original) (raw)

A successful pregnancy in transfusion dependent homozygous β-thalassemia: A case report

International Journal of Gynecology & Obstetrics, 1982

A successful pregnancy in transfusion dependen t homozygous fi-thalassemia; a case report. Int J Gynaecol Obstet 20: 319-322, 1982 A rare case of successful pregnancy in a 26year-old woman with transfusion dependen t homozygous fl+-thalassemia is described. Following the delivery she became amenorrheic with no evidence of ovarian or pituitary j&lure. Transient fertility is most unusual in female patients who otherwise present with a severe clinical course of the disease.

Outcome and management of pregnancy in women with thalassaemia in Cyprus

We describe the management and clinical outcome of pregnancies among 100 Greek Cypriot women with thalassaemia: 88 with thalassaemia major and 12 with thalassaemia intermedia. A total of 152 successful pregnancies and 161 deliveries were included. All patients had endocrine assessment and frequent ferritin measurements. Multiple successful pregnancies included 7 twins and 1 triple pregnancy. Pregnant thalassaemics required significantly larger amount of total blood transfusion during pregnancy. There was a statistically significant increase in the ferritin levels during pregnancy, and levels remained significantly higher after pregnancy. Most pregnancies resulted in delivery of full-term healthy babies, and obstetric complications were rare, although some problems were encountered.

Beta-Thalassemia major and pregnancy.

OBJECTIVE: It was studied the clinical management and the medical outcomes of 6 pregnancies in 5 women affected by Beta Thalassemia major, based on last guidelines and pharmacological treatments. BACKGROUND: Paediatric Department and Department of Obstetrics and Gynaecology of the University of Catania. METHODS: These patients were taken among a group of 116 women affected by beta-thalassemia major divided into three subgroups, according to the characteristics of their menstrual cycle: 1) women with primitive amenorrhoea, 2) women with secondary amenorrhoea and 3) women with normal menstruation. Only one woman, affected by primitive amenorrhoea, needed the induction of ovulation. An accurate and detailed pre-pregnancy assessment was effected before each conception. This was constituted by a series of essays, including checks for diabetes and hypothyroidism, for B and C hepatitis and for blood group antibodies. Moreover were evaluated: cardiac function, rubella immunity and transaminases. Other pregnancy monitoring, and cares during labour and delivery were effected according to usual obstetrics practice. RESULTS: All the women were in labour when they were 38 week pregnant, and the outcome were six healthy babies born at term. There were no complications related to the pregnancy and to the immediate outcome after delivery. CONCLUSIONS: The improvements of current treatments, especially in the management of iron deposits, the prolongation of survival rate, will result in a continuous increase of pregnancies in thalassemic women. Pregnancy is now a real possibility for women affected by such disease. Although numerous complications can occur, vigilant monitoring by both experienced obstetricians and hematologists can lead to successful pregnancy outcomes (Tab. 1, Fig. 1, Ref. 16).

Thalassemic mothers and their babies

The Southeast Asian journal of tropical medicine and public health, 2009

Thirty-two mothers with thalassemia, more than half of whom had hemoglobin H disease with or without other forms of thalassemia or hemoglobinopathies along with their 46 children were evaluated. The mean maternal hematocrit was 22.2% and the mean maternal body mass index was 18.7. The majority of women were not transfused during pregnancy. Eight point seven percent developed toxemia of pregnancy. All had spontaneous labor, 69.5% had a normal vaginal delivery and 23.9% had a cesarean section. The mean infant birth weight was 2,542.2 grams. Low birth weight was found in 34.7%; no extremely low birth weights occurred.

Pregnancy outcomes amongst thalassemia traits

Archives of Gynecology and Obstetrics, 2013

Objective To compare the pregnancy outcome between pregnancies affected and not affected by thalassemia trait. Methods A retrospective case-control cohort study was conducted on singleton pregnant women who attended antenatal care and delivered at Songklanagarind Hospital. All of the participating thalassemia trait pregnant women were diagnosed based on hemoglobin typing and/or DNA analysis. A ratio of around 1-1 was used to compare their pregnancy outcomes with normal pregnant women. Results Seven hundred thirty-nine thalassemia trait and 799 normal pregnant women were included in the study. All of the women were Thai nationals living in the Southern Region of Thailand and nearly all of them had spontaneously conceived. Maternal complication rates of gestational diabetes, preterm birth, antepartum bleeding, postpartum bleeding, shoulder dystocia and puerperal morbidity, and the rates of neonatal complications: macrosomia, fetal weight \2,000 g, intrauterine growth restriction (IUGR), stillbirth, low Apgar score (\7) at 1 and 5 min and NICU admission, were not significantly different between the two groups. The rate of pre-eclampsia, however, was significantly different, with RRs of 1.73 (CI 1.01-3.00). Conclusion The thalassemia trait condition did not affect the risk of gestational diabetes, postpartum hemorrhage, stillbirth, preterm birth and puerperal morbidity. However, pre-eclampsia should be warranted especially among nulliparous and high-BMI pregnant women.

Pregnancy Complications in a-Thalassemia (Hemoglobinopathy H): A Case Study

Case Reports in Obstetrics and Gynecology, 2018

Thalassemia intermedia (TI) is a clinical definition which represents a wide spectrum of thalassemia genotypes but mainly includes patients who do not require or only occasionally require transfusion. An uncommon case of a 32-year-old Greek woman, para 1, at the 22nd week + day 3 of gestation with thalassemia intermedia (she was splenectomized), where her pregnancy was complicated with portal vein thrombosis, splenic thrombosis, and partial HELLP, is described. This is a generally uncommon event in thalassemia intermedia. She had no transfusion as her hematologist consulted and she took anticoagulation therapy. Thus, we present for the first time in the literature a case of HbH a-thalassemia pregnant woman whose pregnancy was complicated with portal vein thrombosis, splenic vein thrombosis, and partial HELLP; she was treated with anticoagulation therapy and she had a successful outcome.

Antenatal diagnosis of thalassaemia major

British Medical Journal, 1978

W WOOD, PHD, university lecturer J B CLEGG, PHD, university lecturer D J WEATHERALL, FRCP, FRS, professor of carrying a fetus with homozygous r-thalassaemia. A presumptive diagnosis of homozygous P-thalassaemia was made in four cases, and the pregnancy was terminated. An inconclusive answer was obtained in one case, and the patient also chose to have her pregnancy terminated. Two fetuses were lost as a result of the procedure. Of the remaining 15 pregnancies, 13 proceeded to term and two to 36 weeks; in each case a normal infant or one heterozygous for r-thalassaemia was delivered.