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The Emerging Role of Liver Stiffness Measurement in Transfusion Dependent Thalassemia.

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Pregnancy in Thalassemia.

Raffaella Origa1, Federica Comitini2

  • 1Ospedale Pediatrico Microcitemico 'A. Cao', A.O. 'G. Brotzu', Cagliari, Italy.

Mediterranean Journal of Hematology and Infectious Diseases
|March 13, 2019
PubMed
Summary

Advances in thalassemia treatment allow more patients to have children. Careful preconception management and multidisciplinary care are key for successful pregnancies in women with thalassemia.

Area of Science:

  • Hematology
  • Reproductive Medicine
  • Maternal-Fetal Medicine

Background:

  • Therapeutic advances have improved life expectancy and quality of life for thalassemia patients.
  • Increased reproductive potential and desire for children in thalassemia patients.
  • Hundreds of successful pregnancies reported with careful management.

Purpose of the Study:

  • To review the management of pregnancy in women with thalassemia.
  • To highlight the importance of preconception care and multidisciplinary teams.
  • To discuss risks and recommendations during pregnancy and postpartum.

Main Methods:

  • Review of reported pregnancies in thalassemia patients.
  • Discussion of multidisciplinary team involvement (cardiology, endocrinology, gynecology, thalassemia expert).
Keywords:
CounsellingHemoglobin H diseasePregnancyThalassemia intermediaThalassemia major

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  • Analysis of recommendations for hemoglobin levels, chelation therapy, blood transfusions, and thrombosis prophylaxis.

    • Main Results:

    • Successful gestation and labor are achievable with proper preconception management.
    • Maintaining hemoglobin >10 g/dL is crucial for fetal growth.
    • Risks include alloimmune anemia in non-transfusion-dependent patients and increased thrombosis.

    Conclusions:

    • Pregnancy in thalassemia patients requires careful preconception planning and a multidisciplinary approach.
    • Close maternal and fetal monitoring is essential throughout gestation.
    • Risk-based management, including potential chelation and thrombosis prophylaxis, is recommended.