Pregnancy outcome in patients with  -thalassemia intermedia at two tertiary care centers, in Beirut and Milan

Nassar, Anwar H.; Naja, Mohammed; Cesaretti, Claudia; Eprassi, Bruno; Cappellini, Maria Domenica; Taher, Ali T.

doi:10.3324/haematol.13152

Cited by 55 publications

(65 citation statements)

References 10 publications

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“…16,17 Further studies are needed to clarify whether this difference could be due to the different sample size in our study compared with other studies, or whether more complex factors are involved.…”

Section: Discussionmentioning

confidence: 73%

“…16 There are reports of increased risk of abortion, pre-term delivery, intrauterine growth restriction and thromboembolism in pregnant women with thalassemia intermedia. 16,17 The aim of this study was to investigate the methods of conception and delivery, as well as the course and outcome of pregnancy including transfusions, iron overload and chelation in a large population of Italian women with thalassemia major and thalassemia intermedia.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Pregnancy and -thalassemia: an Italian multicenter experience

Origa¹,

Piga²,

Quarta³

et al. 2009

Haematologica

107

141

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BackgroundRecent 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. Design and MethodsWe 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. ResultsAmong 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. ConclusionsProvided 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.Key words: pregnancy, thalassemia major, thalassemia intermedia, hypogonadism, assisted reproduction.Citation: Origa R, Piga A, Quarta G, Forni GL, Longo F, Melpignano A, and Galanello R. Pregnancy and β-thalassemia: an Italian multicenter experience. Haematologica. 2010; 95:376-381. doi:10.3324/haematol.2009 This is an open-access paper.Pregnancy and β β-thalassemia: an Italian multicenter experience

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Section: Discussionmentioning

confidence: 73%

Section: Introductionmentioning

confidence: 99%

Pregnancy and -thalassemia: an Italian multicenter experience

Origa¹,

Piga²,

Quarta³

et al. 2009

Haematologica

107

141

View full text Add to dashboard Cite

show abstract

“…The most threatening problem was severe alloimmune anemia complicating the course of pregnancy in a previously minimally transfused woman. The same problem had been previously reported by other authors, 17,18 and should be kept in mind when counseling a woman with thalassemia, especially thalassemia intermedia, who wants to become pregnamt. In fact, this complication is most often observed in patients starting transfusion therapy after the first few years of life, and should be a major concern when previously untransfused patients require transfusion during pregnancy.…”

mentioning

confidence: 77%

The life of patients with thalassemia major

2010

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“…In pregnant women with TI, experience reveals an increased risk of abortion, pre-term delivery, intrauterine growth restriction, Caesarean section delivery, and thromboembolic events (Nassar et al, 2008). Although the use of blood transfusions may be required to address these complications, the risk of alloimmunization in transfusion-naive women should always be taken into consideration.…”

Section: Other Considerationsmentioning

confidence: 99%

Optimal management of β thalassaemia intermedia

et al. 2011

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SummaryOur understanding of the molecular and pathophysiological mechanisms underlying the disease process in patients with b thalassaemia intermedia (TI) has substantially increased over the past decade. The hallmark of disease process in patients with TI includes ineffective erythropoiesis, chronic haemolytic anaemia, and iron overload. There are a number of options currently available for managing patients with TI including splenectomy, transfusion therapy, iron chelation therapy, modulation of fetal haemoglobin production, and several other agents targeting specific clinical complications. Limited studies assessed the efficacy and safety of these modalities; hence, there are currently no clear guidelines for managing patients with TI. Until solid evidence-based guidelines are available, individualised treatment should be entertained.

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Pregnancy outcome in patients with -thalassemia intermedia at two tertiary care centers, in Beirut and Milan

Cited by 55 publications

References 10 publications

Pregnancy and -thalassemia: an Italian multicenter experience

Pregnancy and -thalassemia: an Italian multicenter experience

The life of patients with thalassemia major

Optimal management of β thalassaemia intermedia

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