Neonatology and Perinatology

Biography

Biography: Terence T Lao

Abstract

Thalassemia is the commonest monogenetic disease. Homozygous thalassemia manifests as severe anemia. The manifestation of the heterozygous form can vary from totally asymptomatic and being identified only on antenatal screening, to severe anemia even requiring blood transfusion. It is increasingly encountered outside the Mediterranean region, Africa, Middle East, and South East Asia, due to immigration. Pregnancy, previously uncommon in homozygous ß-thalassemia, is encountered increasingly due to improved management and assisted reproduction technology, but preconceptional problems that include anemia, iron overload, cardiac dysfunction, thromboembolism, alloimmunization, infections, and endocrine and bone disorders, could impact on maternal and obstetric outcome. Successful pregnancy in thalassemia trait carriers and women with hemoglobin H disease is more common, and the pregnancy outcome is usually similar to normal women, although there is still increased risk of obstetric and perinatal complications in case of severe anemia or iron overload. Prenatal diagnosis to exclude fetal homozygous thalassemia and other congenital anomalies, together with close monitoring of the pregnancy, would optimize pregnancy outcome. Further research is warranted to elucidate the fetal safety of iron chelation therapy, and potential impact of pregnancy on long-term maternal health outcome, especially following occurrence of maternal complications.