How to Manage Thalassaemia During Pregnancy: Expert Advice from the BSH
A comprehensive multidisciplinary approach is essential for managing conception and pregnancy in patients with a variety of medical conditions, including obesity, diabetes, and hypertension. Thalassaemia, an inherited blood disorder that is a prevalent cause of anaemia, is no exception. In response to this need, the British Society for Hematology (BSH) has recently updated its guidelines for managing conception and pregnancy in thalassemia patients. These guidelines were published in the British Journal of Hematology.
The primary complications associated with thalassaemia are anaemia and iron overload, both of which require vigilant monitoring and aggressive management throughout pregnancy. Furthermore, individuals who have undergone splenectomies—a common treatment for thalassaemia—may face an increased risk of thrombotic diseases during pregnancy.
“With thalassaemia patients aging and many now achieving optimal chelation, there is increasing hope for them to start families,” explains Dr. Farrukh Shah, MBBS, FRCPath, MDRes, MBE, lead author of the newly published guidelines from the Department of Hematology at Whittington Health, London. “Comprehensive guidelines on managing conception and pregnancy in thalassemia patients are crucial not only to support patients in the U.K. but also globally where the disease burden is significantly higher.”
The guidelines include recommendations on preconception optimization, addressing hypogonadism, antenatal care, intrapartum care, and postnatal care. They classify recommendations using GRADE 1 for “strong” recommendations and GRADE 2 for “weak,” with literature strength ratings ranging from A (strongest) to D (weakest).
The authors stress the importance of a multidisciplinary approach to treat fertility and pregnancy issues in thalassaemia. “Creating these multidisciplinary guidelines required detailed input from endocrinologists experienced in male and female infertility along with obstetricians and haematologists,” Dr. Shah affirmed. “We were fortunate to receive endorsements from the Endocrine Society and invaluable feedback from the Royal College of Obstetricians and Gynecologists’ guidelines committee.”
Source: MedPage Today
