Thalassaemia, iron, pregnancy

British medical journal 09/1975; 3(5982):509-11. DOI: 10.1136/bmj.3.5982.509
Source: PubMed


Haematological values of 35 pregnant women with beta-thalassaemia trait were followed during pregnancy. The discriminant function, calculated from haematological indices, was of no value in diagnosing beta-thalassaemia trait during pregnancy. Initially patients were given iron supplements only if the serum iron and total iron binding capacity levels indicated iron deficiency, but bone marrow biopsies performed in the first 22 patients at 32 weeks indicated deficient iron stores. These patients were therefore given iron irrespective of their serum iron level. All subsequent patients with beta-thalassaemia were also put on iron routinely at booking. Retrospectively the patients were divided into two groups. Patients in group 1 (18 patients) had received iron for less than 12 weeks, and their haemoglobin levels fell significantly during pregnancy (P less than 0-001). Haemoglobin levels in 16 patients who had received iron for more than 12 weeks (group 2), however, did not fall significantly during pregnancy (P less than 0-6). It is suggested (contrary to common practice) that patients with beta-thalassaemia trait should be given iron supplements during pregnancy. Serum folate and vitamin B12 levels did not change significantly in these patients and there was no increase in the incidence of maternal or fetal complications.

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    • "f-thalassaemia trait and iron deficiency should, of course, be excluded. The limitations of this formula , ie, that it must not be used in patients with iron deficiency polycythaemia or clinical states with haemodilution such as splenomegaly, pregnancy, etc. (England and Fraser, 1973; Hegde et al., 1975) should be borne in mind. "
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    ABSTRACT: A number of patients of Mediterranean and Asian origins were found to have unexplained microcytic hypochromic red blood cells. Iron deficiency and beta-thalassaemia trait were both satisfactorily excluded in all of them. The haematological indices of these patients, obtained on a Coulter Model 'S' Counter, were found to be very similar to those seen in obligatory heterozygotes for alpha-thalassaemia. It is postulated that these patients were also carriers for alpha-thalassaemia. Subsequent investigation of some of these patients showed the characteristically reduced rates of alpha-chain synthesis seen in this condition. The discriminant function of England and Fraser (1973) may be of help in diagnosing this state. alpha-Thalassaemia trait should be considered in all patients of 'high-risk' ethnic origins with a blood picture suggestive of beta-thalassaemia trait but in whom the levels of Hb A2 and Hb F are within normal limits.
    Preview · Article · Oct 1977 · Journal of Clinical Pathology
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    ABSTRACT: -Thalassemia minor and polycythemia rubra vera (PRV) are hematologic disorders that give oppo- site results on some blood laboratory studies. Beyond this case report, only one other instance of the simultaneous occurrence of β- thalassemia minor and PRV within a patient has been reported.1 When these conditions occur together within a patient, the effects of one of the disorders can blunt the effects of the other, rendering a physician less able to make a timely diagnosis of one or both of the disorders. This article describes a patient with a history of β- thalassemia minor and newly diagnosed coronary artery disease and PRV. The effects of the PRV had been somewhat masked by the patient's β- thalassemia minor; in effect, results from the patient's cardiac evaluation led to her PRV being dis- covered. In addition to this case presentation, the patho- physiology, diagnosis, and treatment of β - thalassemia minor and PRV are discussed.
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    ABSTRACT: A pregnant patient with anaemia due to beta-thalassaemia trait is described. The patient was apparently of British stock.
    No preview · Article · Nov 1977 · British Journal of Obstetrics and Gynaecology
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