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Precautions to be taken by a pregnant lady with Thalassemia - Online Doctor Chats

Date : 21-Feb-2012
User rating for this question
Very Good Posted in: Blood Disorders
Answered by

General & Family Physician
Practicing since : 2005
Answered : 2307 Questions
User :   My wife is thalesemia minor and her blood groupd is B Rh Negative. She is into her 7th month of pregnancy and her Haemoglobin level is 9.5. What kind of specific precautions we need to take. Also is there a need to arrange for blood during her delivery.
I am not thalesemia carrier and my blood group is B Rh Positive
User :   ok
Doctor :   for the low hemoglobin and the thalessemia, you will need to arrange blood
Doctor :   for the Rh incompatibility, she will need to be given Anti-D injection post delivery
User :   she is taking iron suppleements
User :   but i am not sure if a thalesemia minor should take iron supplements
Doctor :   ok, she has to continue taking them untill she is breastfeeding the baby even after the delivery
Doctor :   iron suppliments are given to make sure that hemoglobin levels are at a accepted level
Doctor :   the thalessemia condition is different
User :   but is her body able to break that iron
User :   also her doctor told that if her haemoglobin does not increase she has to take iron injections
User :   that scares me
Doctor :   yes the hemoglobin will get broken/metabolized in spleen
Doctor :   there is nothing to be scared of the iron injections
User :   is it...
Doctor :   it is given sometimes to pregnant women to help increase hemoglobin levels faster when nearing delivery
User :   i was told tht thal minors should avoid external source of iron
User :   her haemoglobin has never gone above 10
Doctor :   as she is already on iron suppliments, let her take foods that are rich in iron to help her
User :   and i dont think it will increase beyond 10
Doctor :   ok
User :   i am asking... sorry if it sounded like a statement
Doctor :   for pregnancy, a level upto 10 is considered to be fine, it should not be below 10
Doctor :   so focus on dietary sources also along with the suppliments
User :   what are the other options increase haemoglobin level
Doctor :   since she is Thalessemia minor, there will be defective hemoglobin production
Doctor :   which is responsible for her anemia, but it can be taken care by few measures like diet and suppliments
User :   ok
User :   and that Anti-D injection
User :   that is only after delivery
Doctor :   yes anti-D is only after delivery to be given within 48 hours
User :   since her blood group is B -ve, how common is tht
User :   or we will have to pre arrange
Doctor :   also as per the studies, Thalessemia minor patients do not need specific therapy, it is the thalessemia major patients who require treatment and therapy.
Doctor :   you will need to pre-arrange blood for her,
Doctor :   the hospital where you planning her delivery is to be contacted
Doctor :   and blood pre-arranged when the delivery date comes near
User :   and one more question
User :   her WBC is 0000
Doctor :   yes, please proceed
User :   is that any cause of worry
Doctor :   was differential counts and peripheral smear done? if yes what did they reveal?
User :   yes they whr
User :   but i dont have the reports in front of me right now
Doctor :   if the peripheral smear did not show any abnormal cells, you can relax, it will be fine after her delivery
User :   ok
User :   i will keep this in mind and check the report
Doctor :   if it is abnormal, then you need to discuss the report with a hematologist
User :   ok
Doctor :   have you followed what I have said?
User :   yes i did
Doctor :   is there anything else I can help you with?
User :   how much of a weight gain does a woman go thru
User :   she has gained only 7.5 kgs till now
User :   since start to now
Doctor :   on an average, it varies between 10-12 kgs for an average indian woman
User :   ok
Doctor :   it will also depend on her built
Doctor :   if she is of a small built, she gain less weight
User :   can you recommend me a gynaec in mumbai
Doctor :   yes, i can help you by giving list of gynecologists in mumbai
User :   cool
User :   where are you based out of ... if you dont mind Doctor :   this link will give you list of gynecologists in Mumbai
Doctor :   I am based in Bangalore.
User :   currently i was planning for a maternity home
User :   but i think if she might need blood
User :   we better book a hospital
Doctor :   yes , and a multispeciality hospital with neonatal ward facility will be better
Doctor :   since she is anemic baby might be of low weight
Doctor :   and need special care in initial few days of life
User :   so generally all thal minors are anemic
User :   like they have haemoglobin less thn 10
Doctor :   if so, let her continue her further check-ups in the hospital you are planning to get the delivery done.
User :   becos even her mom and brother have the same symptoms
Doctor :   such that the treating gynecologist knows her history
Doctor :   and also arrange for pediatrician while she is delivering
Doctor :   yes thalessemia runs in families
User :   pediatrician for ?
Doctor :   it is a genetic disorder
Doctor :   pediatrician for baby's care after baby is born
User :   is thr a way we can avoid our child having tht
Doctor :   that we cannot tell for sure, if the gene has passed on to it, it will have it,
User :   ok ..
Doctor :   the genetic build up happens at the time of conception, or meeting of sperms and egg
Doctor :   so at this point nothing can be done, but to wait and watch
User :   ok
User :   but is thr some thing that can be done pre planning
Doctor :   for that genetic counseling will help to know chances of thalessemia in next baby
Doctor :   is there anything else you would like to ask me?
User :   i think this should be it for now
User :   if i further questions how can i contact you
Doctor :   you can come on live chat
User :   ok
User :   at what times are you available
User :   sorry to bug you so much..
Doctor :   I am available between 9Am -4PM IST.
Doctor :   I am here to answer your queries. do not be worried
User :   ok.. Thanks for all the guidance
Doctor :   you are welcome
Doctor :   thanks for consulting me. bye for now.
User :   bye
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