Fertility and Pregnancy in Women with Transfusion-Dependent Thalassemia

Carlberg, Katie; Singer, Sylvia T.; Vichinsky, Elliott

doi:10.1016/j.hoc.2017.11.004

Cited by 22 publications

(21 citation statements)

References 71 publications

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“…In this retrospective study, we report the experience of pregnancies in patients with thalassemia major and intermedia and sickle cell disease followed at the Thalassemia Unit of S. Eugenio Hospital of Rome. Moreover we report the maternal and fetal outcomes of the patients comparing with the experiences previously reported in literature (Tuck, 2005;Origa et al, 2010;Leung and Lao, 2012;Voskaridou et al, 2014;Lao, 2017;Carlberg et al, 2018;Jain et al, 2019).…”

Section: Introductionmentioning

confidence: 80%

“…The increase in life expectancy has consequently changed patients' perspectives, leading them to longer-term planning with a consequent increase in their reproductive potential and desire to have children. Hypogonadism still represents an obstacle for some patients, but the progress in assisted reproduction techniques has helped many of them to fulfill this wish (Leung and Lao, 2012;Lao, 2017;Materazzi et al, 2017a;Carlberg et al, 2018;Origa and Comitini, 2019).…”

Section: Introductionmentioning

confidence: 99%

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Pregnancy in Thalassemia and Sickle Cell Disease: The Experience of an Italian Thalassemia Center

Sorrentino

Maffei

Caprari

et al. 2020

Front. Mol. Biosci.

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The life expectancy of thalassemia patients has increased significantly in recent years being the most "elderly" patients approaching or are over 50 years old. Consequently, patients' perspectives have changed, leading them to longer-term planning with a consequent increase in their reproductive potential and desire to have children. Crucial points in the management of pregnancy in thalassemia are the iron chelation therapy before and during pregnancy, the antithrombotic prophylaxis, the management of transfusion therapy according to the modified transfusion requirement, a cardiologic monitoring for hemodynamic changes that expose an increased risk of heart failure. Pregnancy in women with sickle cell disease is still associated with increased rates of maternal and fetal mortality and adverse outcomes. Maternal morbidity may be due to acute sickling crises, thromboembolism, infection, and chronic end-organ dysfunction, while neonatal outcomes may be intrauterine growth retardation, preterm delivery, small infants for gestational age, stillbirth, and neonatal death. The management of pregnancy in thalassemia and sickle cell disease requires to be approached by a multidisciplinary team and followed from the pre-conception phase until the post-partum period with a close monitoring of the maternal and fetal conditions, in order to ensure optimal outcome. This approach requires the application of well-defined protocols that cover all the critical aspects of pregnancies in women affected by these pathologies. We describe our experience of spontaneous and non-spontaneous pregnancies in patients with thalassemia major and intermedia and sickle cell disease followed between 1992 and 2018 at the Thalassemia Unit of S. Eugenio Hospital of Rome.

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Section: Introductionmentioning

confidence: 80%

Section: Introductionmentioning

confidence: 99%

Pregnancy in Thalassemia and Sickle Cell Disease: The Experience of an Italian Thalassemia Center

Sorrentino

Maffei

Caprari

et al. 2020

Front. Mol. Biosci.

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“…Despite this, ovarian function is typically preserved in women with thalassemia, even those suffering from primary or secondary amenorrhea, as evidenced by pregnancies after hormonal stimulation 11. Data on the frequency of failure in ovulation induction or timeline to a successful pregnancy are limited.…”

Section: Fertility In Thalassemiamentioning

confidence: 99%

Pregnancy in Thalassemia

Origa¹,

Comitini²

2019

Mediterr J Hematol Infect Dis

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Therapeutic advances, including the availability of oral iron chelators and new non-invasive methods for early detection and treatment of iron overload, have significantly improved the life expectancy and quality of life of patients with thalassemia, with a consequent increase in their reproductive potential and desire to have children. Hundreds of pregnancies have been reported so far, highlighting that women carefully managed during preconception usually carry out a successful gestation and labour, both in case of spontaneous conception and use of assisted reproductive techniques. A multidisciplinary team including a cardiologist, an endocrinologist and a gynaecologist, with the supervision of an expert in beta-thalassemia should be involved. During pregnancy, a close follow-up of maternal disorders and of the baby's status is recommended. Haemoglobin should be maintained over 10 g/dL to to allow normal foetal growth. Chelators are not recommended during pregnancy; nevertheless, it may reasonable to consider restarting chelation therapy with desferrioxamine towards the end of the second trimester when the potential benefit outweighs the potential foetal risk. Women with non-transfusion-dependent thalassemia who have never previously been transfused or who have received only minimal transfusion therapy are at risk of severe alloimmune anaemia if blood transfusions are required during pregnancy. Since pregnancy increases the risk of thrombosis three-fold to four-fold and thalassemia is also a hypercoagulable state, the recommendation is to keep women who are at higher risk -such as those who are not regularly transfused and those splenectomised- on prophylaxis during pregnancy and during the postpartum period. Keywords:Pregnancy, Thalassemia major, Thalassemia intermedia, Haemoglobin H disease, Counselling

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“…First Hypothesis: The women should have equal opportunities to participate in socio economic and political frameworks. Carlberg, Singer, and Vichinsky (2018) and the female empowerment it is necessary that women should be in a position to act freely, and acquire power to exercise their rights and potentials. Thus, women empowerment can be described as a process through which women get an equal and equitable status and position in a society of individual variables.…”

Section: Discussion and Findingmentioning

confidence: 99%

Socio-Economic Factors of Empowerment in Developing Countries

Khan

Xinxin

Kong

et al. 2020

Asian Journal of Economics and Empirical Research

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The study is carried to identify the main socio economic cultural and political view determinants of women empowerment in the developing countries. The highest determination of the study is to analyze and identify the variables through which the process of women empowerment can be measured. This study is based on secondary data and reported to analyze the empowerment factor of women in 124 developing countries, the data was ordinal in nature and randomly selected from the population. The main investigation of this research study to analyzed the relationship of women fertility, socioeconomic and political factor on the women empowerment. After conducting a cross sectional study for the most recent period, the findings of study show that the main deterrents towards women disempowerment are attributed as high fertility rates, high maternal mortality, gender inequality, lack of female"s access towards education, health and economic opportunities, lack of leadership and decision making qualities. It is found that a patriarchal culture is equally responsible for women in sufferings and disempowerment. However, democracy and democratic culture can contribute well in upgrading the process of women empowerment in developing countries.

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Fertility and Pregnancy in Women with Transfusion-Dependent Thalassemia

Cited by 22 publications

References 71 publications

Pregnancy in Thalassemia and Sickle Cell Disease: The Experience of an Italian Thalassemia Center

Pregnancy in Thalassemia and Sickle Cell Disease: The Experience of an Italian Thalassemia Center

Pregnancy in Thalassemia

Socio-Economic Factors of Empowerment in Developing Countries

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