World Thalassemia Day: How to reduce the risk of thalassemia in pregnancy

Pregnant women go through many changes in their blood circulation as their blood volume increases. Did you know that this causes anemia in more than 50 percent of women? Iron nutritional deficiency remains a major challenge in developing countries and is the main reason for maternal deaths that occur due to excessive blood loss during childbirth. According to a senior gynecology expert, a large portion of anemia cases that occur during pregnancy are due to iron deficiency and the rest should be evaluated for thalassemia or sickle cell defects.

Understanding Thalassemia in Pregnant Women

Thalassemia is an inherited (genetic) blood disorder. It is due to a defect in the rate of globin chain synthesis, which leads to inefficient blood cell formation and a reduced lifespan of red blood cells. The disease can vary from the minimal suppression of the synthesis of the affected genes to the complete absence. The most prevalent single gene condition in India is beta-thalassemia. Every year, more than 9,000 babies are born with the disease, explains Dr. Aruna Kumari, Consultant Obstetrics and Gynaecology, Cloudnine Group of Hospitals, Bellandur, Bangalore.

Understanding thalassemia in pregnant women. Image Courtesy: Shutterstock

“Quantitative hb electrophoresis is required for the diagnosis of beta-thalassemia and should be suspected in cases of elevated HbA2 (>3.5 percent) and HbF,” he adds. If the result is positive, you should tell your family so they can check it out in case you are planning to have a baby.

Also read: Thalassemia needs more attention. Here is everything you MUST know to deal with it.

Beta-thalassemia minor

It is the most common and prevalent inherited disorder in which one beta globin gene is affected and the other is normal. Beta-thalassemia minor shows more significant symptoms of anemia during pregnancy, particularly during the second and early third trimesters of pregnancy. The condition is not associated with significant negative pregnancy outcomes. However, it requires close monitoring by a multidisciplinary team, explains Dr Mitu Shrikhande, Director of Hematology, Fortis Hospital, Vasant Kunj, New Delhi.

thalassemia major

Thalassemia major is the severe form of the spectrum, in which the baby needs a blood transfusion every 3 to 4 weeks depending on the hb. The only cure for the condition is bone marrow transplantation.

The results of tests for thalassemia before pregnancy are important to know if the silent carrier of the condition is present in you or your partner. If either parent is diagnosed with the disease, there is a 25 percent chance that the baby will contract the disease, a 50 percent chance of becoming a carrier, and a 25 percent chance of contracting the disease.

Thalassemia in pregnant women
Thalassemia in pregnant women can also be dangerous for the baby. Image courtesy: Adobe Stock

How to reduce the risk of thalassemia?

Dr. Kumari and Dr. Shrikhande list the following ways to reduce the risk or control thalassemia during pregnancy:

  • Awareness is key to preventing the birth of a child with thalassemia major or minor in the baby.
  • Women should receive treatment for iron deficiency if they are at risk or have been diagnosed with it.
  • It is essential to optimize Hb by taking the right diet and supplements and avoiding excess iron.
  • Folic acid supplementation in the periconceptional period may prevent neural tube defects.
  • If asplenic (HBS/beta Thal), pneumococcal, Haemophilus influenzae, and meningococcal vaccines should be given.
  • Period growth monitoring and hb levels should be monitored during the antenatal period to prevent intrauterine growth restriction (IUGR) or preterm deliveries.
  • Although it usually occurs later in the gestational period, ultrasound is still beneficial in detecting hydrops fetalis (a sign indicating an underlying health problem). Intrauterine blood transfusions have shown good results in the fetus with hydrops fetalis.

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