Thalassemia and pregnancy

Thalassemia and pregnancy

Thalassemia is a blood disease resulting from hemoglobinopathy.
thalassemia leads to chronic anemia.
The degree of anemia in thalassemia patients depends on the degree of genetic defect.
What are the principles of treatment for thalassemia patients?
**Blood transfusion
** Removing iron accumulated in the organs

How does thalassemia affect pregnant women?
**Chronic anemia
**The need for blood transfusion and the risks associated with blood transfusion
** Iron accumulation in the organs, which affects the functions of the organs

How does thalassemia affect the fetus?
**It may lead to restriction of fetal growth 
**The fetus inherits thalassemia from the parents

How are the maternal organs affected by iron accumulation?
** Heart: myocardial failure
**Pancreas: diabetes
**Thyroid gland: hypothyroid
**Liver: cirrhosis and gallstone formation
**Bones: osteoporosis

How is thalassemia inherited?
Autosomal recessive, meaning two genes must combine in the affected person for symptoms of severe disease to appear.
A person carrying the gene suffers from mild chronic anemia

Does thalassemia lead to infertility?
Yes, due to iron accumulation in the testicles/ovaries, which leads to their damage and loss of function

How can the disease be prevented from being transmitted to offspring if the parents carry the affected gene?
By performing in vitro fertilization and testing the embryos before returning them into the uterus, and returning only unaffected embryos

What is the follow-up of a pregnant woman with thalassemia?
** Monitoring the growth of the fetus regularly
** Diabetes screening and follow-up
** Examination and follow-up of thyroid function
** Checking CBC and iron stores and following them up
**Blood transfusion when needed
**Checking blood type and antibodies regularly

If a pregnant woman has thalassemia, should she be given anticoagulants?
Depending on the platelet count and the presence of a history of splenectomy, we may give aspirin pills only or aspirin pills with heparin injections.

Is it necessary for a woman with thalassemia to give birth by caesarean section?
No, it depends on the course of pregnancy and other health factors

It should be noted that a pregnant woman with thalassemia is at high risk of blood clots formation after giving birth, and for this reason she must be given preventive doses of heparin.

Can women with thalassemia breastfeed?
Yes

Dr Najeeb Layyous  F.R.C.O.G

Consultant Obstetrician, Gynecologist and Infertility Specialist