This guideline from RCOG is about the management of beta thalassaemia in pregnancy. I'm not going to go into much detail as it's a rare condition. It is useful to know this guideline is there if you have an affected lady.
- May have trouble conceiving due to endocrine problems
- High risk pregnancies, so need pre-pregnancy counselling by haematology/obstetrics
- There is a list of things that need to be done. Hopefully this will be picked up by haematology/obstetrics, but you may need to refer to it if you have a lady planning to conceive.
- Need folic acid 5mg preconception and throughout pregnancy
- They will have shared care with haematology/obstetrics.
- They have high risk of cardiomyopathy, so they will need cardiac assessment at 28w and otherwise if required.
- They need an early scan at 7-9/40 because of the high miscarriage risk and will have extra scans after 20/40 to monitor growth.
- There is a high thrombotic risk:
- Thalassaemia + splenectomy OR platelets > 600 → aspirin 75mg per day
- Thalassaemia + splenectomy AND platelets > 600 → clexane