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Dr. Andrew Rynne

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Pregnant. Blood test showed low MCV and MCH level. Chances of child having thalassemia?

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Dr. Das Arindam

General & Family Physician

Practicing since :2008

Answered : 1416 Questions

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Posted on Tue, 22 Jan 2013 in Pregnancy
Question: Hi ,
I am XXXXXXX from New Delhi. My wife is 3 weeks pregnant. Today an utrasound was carried out and it was told by our doctor that every thing is ok. Also doctors has seen the hemoglobin test report. The test report findings are HB F is 26.90% ( SHOULD BE <1.50) , HB A2 is 2.20 ( SHOULD BE BETWEEN 1.50 TO 3.00), and Hemoglobin is 12 g/dL. doctors looks bit worried after seeing the report and asked me to go for Hemoglobin HPCL test. is there any chance that our child may suffer from thalaseemia!!!
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Answered by Dr. Das Arindam 32 minutes later
Hello,
Thank you for posting a query.

After seeing the reports, I have found that the MCV and MCH are lower than normal value. It may be due to the iron deficiency that usually occurs at this stage of pregnancy. Consult with your treating doctor about it.

Now, the Hemoglobin report.

In thalassemia carrier state, the HbA2 level should be more than 4%. Your wife’s HbA2 is below that range. So, thalassemia carrier state is not possible.

In some individual, HbF level may be high idiopathically. That means, no definite disease condition is present. But persistently high level of fetal hemoglobin is detected.

In this situation we generally advice to repeat the HPLC test from another laboratory. If that report also becomes inconclusive, then we generally advice to do a parental study. That means HPLC study of the parents of your wife to rule out possibility of any mild abnormality in hemoglobin.

lastly, it is mandatory to do a HPLC test of both husband and wife at this stage. Because, thalassemia is a genetic disease. If any one of you has any abnormality that has a chance to get transmitted in your baby.

So, without your HPLC report, it is not possible to comment whether you child may suffer from thalassemia or not.

Hope this information suffices. Let me know, if you have any more question.

Regards.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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