Pregnancy and β-thalassemia: an Italian multicenter experience

Recent advances in the management of thalassemia have significantly improved life expectancy and quality of life of patients with this hemoglobinopathy, with a consequent increase in their reproductive potential and desire to have children. We describe the methods of conception and delivery, as well...

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Veröffentlicht in:Haematologica (Roma) Jg. 95; H. 3; S. 376 - 381
Hauptverfasser: Origa, R., Piga, A., Quarta, G., Forni, G. L., Longo, F., Melpignano, A., Galanello, R.
Format: Journal Article
Sprache:Englisch
Veröffentlicht: Pavia Ferrata Storti Foundation 01.03.2010
Schlagworte:
Adult
Anemias. Hemoglobinopathies
beta-Thalassemia - complications
beta-Thalassemia - therapy
Biological and medical sciences
Blood Transfusion
Chelation Therapy
Diseases of red blood cells
Female
Ferritins - blood
Gonadotropins - administration & dosage
Hematologic and hematopoietic diseases
Humans
Infant, Newborn
Iron Overload - prevention & control
Italy
Medical sciences
Original
Pregnancy
Pregnancy Complications, Hematologic - therapy
Pregnancy Outcome
Reproductive Techniques, Assisted
Treatment Outcome
Triplets
Twins
Young Adult
Italy
Europe
thalassemia major
Hemoglobinopathy
Hematology
Multicenter study
Hemopathy
thalassemia intermedia
Hypogonadism
Genetic disease
Genital diseases
Pregnancy
Reproduction
assisted reproduction
Hemolytic anemia
β-Thalassemia
Female
ISSN:0390-6078, 1592-8721, 1592-8721
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Zusammenfassung:Recent advances in the management of thalassemia have significantly improved life expectancy and quality of life of patients with this hemoglobinopathy, with a consequent increase in their reproductive potential and desire to have children. We describe the methods of conception and delivery, as well as the course and outcome of pregnancy including transfusions, iron overload and chelation in 46 women with thalassemia major (58 pregnancies) and in 11 women with thalassemia intermedia (17 pregnancies). Conception was achieved after gonadotrophin-induced ovulation in 33 of the women with thalassemia major and spontaneously in all of those with thalassemia intermedia. Among the women with thalassemia major, 91% of the pregnancies resulted in successful delivery of 45 singleton live-born neonates, five sets of twins and one set of triplets. No secondary complications of iron overload developed or worsened during pregnancy. When considering only the singleton pregnancies, the proportion of babies with intrauterine growth retardation did not differ from that reported in the general Italian population. The high prevalence of pre-term births (32.7%) was mostly related to multiple pregnancies and precautionary reasons. Pregnancy was safe in most women with thalassemia major or intermedia. However, women with thalassemia intermedia who had never previously been transfused or who had received only minimal transfusion therapy were at risk of severe alloimmune anemia if blood transfusions were required during pregnancy. Provided that a multidisciplinary team is available, pregnancy is possible, safe and usually has a favorable outcome in patients with thalassemia. In women with hypogonadotropic hypogonadism, gonadal function is usually intact and fertility is usually retrievable.
Bibliographie:ObjectType-Article-1
SourceType-Scholarly Journals-1
ObjectType-Feature-2
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ISSN:0390-6078
1592-8721
1592-8721
DOI:10.3324/haematol.2009.012393