RCOG | Management of beta thalassaemia in pregnancy

9th July 2014 by Louise Hudman

RCOG | Management of beta thalassaemia in pregnancy

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.

Pre-pregnancy issues

  • 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

During 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

 

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