Transfusion-dependent homozygous β-thalassaemia major: successful pregnancy in five cases

Tampakoudis, P.; Tsatalas, Costas; Mamopoulos, M.; Tantanassis, T.; Christakis, John; Sinakos, Z; Mantalenakis, S.

doi:10.1016/s0301-2115(97)00089-4

Cited by 32 publications

(25 citation statements)

References 16 publications

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“…Regular use of DFO has been shown to be effective in removing excess iron in patients on chronic transfusion and therefore preventing or delaying iron-induced organ damage. However, due to uncertainty of its safety for the developing fetus, it has generally been withheld during pregnancy [1,[3][4][5][6]. Because of the concern over its teratogenic potential, the importance of contraception or preconceptual counseling has been addressed [1].…”

Section: Discussionmentioning

confidence: 99%

“…Despite this general caution in using DFO during pregnancy, review of the literature on pregnant thalassemia women discloses over 40 patients who have received DFO during several weeks or months of gestation, and there is no single documentation of a toxic or teratogenic effect. A total of 11 cases in the various reports have continued the use of DFO in early pregnancy, most of them inadvertantly: four patients up to eight weeks [2,4]; five women up to 16 to 19 weeks of gestation [3,[8][9][10]; and two women up to 21 and 26 weeks [1,10]. All gave birth to normal-appearing infants.…”

Section: Discussionmentioning

confidence: 99%

“…It is well established that the transfusion requirement is increased throughout the pregnancy of thalassemia major patients. This allows proper fetal development and a full-term pregnancy [1][2][3][4]. However, no strategy for the management of the iron overload during gestation has been developed to date.…”

Section: Introductionmentioning

confidence: 99%

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Deferoxamine treatment during pregnancy: Is it harmful?

Singer¹,

Vichinsky²

1999

Am. J. Hematol.

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The use of the iron chelator, Deferoxamine (DFO), in pregnant thalassemia women with iron overload has been generally avoided due to fear of its potential teratogenicity. We describe a case of a pregnant thalassemia major patient with iron overload, who received DFO throughout her second and third trimesters and gave birth to a healthy infant, who had no findings of DFO toxicity at birth and at a later follow-up. Review of the literature discloses over 40 other cases in which DFO was given in various periods of gestation without evidence of teratogenic effect. Sufficient documentation exists, therefore, to suggest that DFO can be considered for use in cases of pregnant women who need iron chelation treatment. Am. J. Hematol. 60:24-26, 1999.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Deferoxamine treatment during pregnancy: Is it harmful?

Singer¹,

Vichinsky²

1999

Am. J. Hematol.

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“…Table expressing the number of married women, the pregnancies, the medium age and the amount of each group, according to a subdivision in three categories -Normal menstruation, Secondary Amenorrhoea and Primitive Amenorrhoea -in reference to the total amount of the 116 patients we studied. maintaining a strict therapeutic regimen, women regularly transfused and well chelated can attempt to become pregnant (7)(8)(9). In this study we describe the evolution and the successful outcome of six at term pregnancies ruled out by fi ve women affected by transfusion dependent beta Thalassemia.…”

mentioning

confidence: 99%

Beta-Thalassemia major and pregnancy

Gulino¹,

Vitale²,

Fauzia³

et al. 2013

BLL

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Abstract:Objective: It was studied the clinical management and the medical outcomes of 6 pregnancies in 5 women affected by Beta Thalassemia major, based on last guidelines and pharmacological treatments. Background: Paediatric Department and Department of Obstetrics and Gynaecology of the University of Catania. Methods: These patients were taken among a group of 116 women affected by beta-thalassemia major divided into three subgroups, according to the characteristics of their menstrual cycle: 1) women with primitive amenorrhoea, 2) women with secondary amenorrhoea and 3) women with normal menstruation. Only one woman, affected by primitive amenorrhoea, needed the induction of ovulation. An accurate and detailed pre-pregnancy assessment was effected before each conception. This was constituted by a series of essays, including checks for diabetes and hypothyroidism, for B and C hepatitis and for blood group antibodies. Moreover were evaluated: cardiac function, rubella immunity and transaminases. Other pregnancy monitoring, and cares during labour and delivery were effected according to usual obstetrics practice. Results: All the women were in labour when they were 38 week pregnant, and the outcome were six healthy babies born at term. There were no complications related to the pregnancy and to the immediate outcome after delivery. Conclusions: The improvements of current treatments, especially in the management of iron deposits, the prolongation of survival rate, will result in a continuous increase of pregnancies in thalassemic women. Pregnancy is now a real possibility for women affected by such disease. Although numerous complications can occur, vigilant monitoring by both experienced obstetricians and hematologists can lead to successful pregnancy outcomes (Tab. 1, Fig. 1

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“…To the Editor: Improvements in managing b-thalassaemia major have allowed many patients to survive beyond puberty. Fertility can, however, be impaired as a result of iron overload-related hypogonadism (1), although assisted reproductive techniques and advances in treating iron overload have increased the number of successful pregnancies in such patients (2)(3)(4)(5)(6)(7)(8)(9). During pregnancy, patients may require additional blood transfusions to treat complications such as pre-eclampsia or severe anaemia, increasing the need for effective iron chelation therapy.…”

mentioning

confidence: 99%