Thalessemia in Pregnancy Flashcards
What is Thalassemia
In thalassemia there is reduced beta globin synthesis having in adequate hb content
Thalassemia’s mode of inheritance
Autosomal recessive
how many babies are born with thalassaemia worldwide.
more than 70,000 babies
What is thalassemia major, intermedi and minor
Major - >7 transfusions / year
Intermedia - <=7 transfusions / year
Minor - no transfusions required
What is the primary cause of death in majority of thalassemia cases ?
Cardiac failure in >50% cases
Which ethnicity has a higher burden of thalassemia ?
South East Asians - India, Pakistan, Bangladesh
African Americans
Mediterraneans
Obstetric risks of thalassemia?
- Anaemia
- Endocrinopathies - hypothyroidism, hypoparathyroidism, DM
- Cardiomyopathy (dt iron overload)
- FGR
Should contraception be used while achieving thalassemia disease optimization?
Yes - even though they have reduced fertility due to hypogonadotrophic hypogonadism
Might even require ovulation induction with Gn to conceive
Contraception for the entire period of prolonged iron chelation therapy to avoid iron overload in pregnancy when there will be reduced or no chelation
Is there any contraindication for any particular contraceptive method with thalassemia
No
Are iron chelators teratogenic ?
When should they be stopped prior to pregnancy?
Which can be used in pregnancy? From when ?
Yes - all are teratogenic in the 1st trimester - deferasirox, deferiprone, desferrioxamine
Stopped 3 months prior
Desferrioxamine - if required from 20 wks GA
Elevated Hb A2 suggestive of
B thalassemia disorder
Elevated Hb F is suggestive of
alpha thalassemia disorder
Hemolysis in individuals with glucose-6-phosphate dehydrogenase deficiency may be triggered by
sulfonamides, nitrofurantoin, or antimalarial agents.
