Angiotensin converting enzyme (ACE)
inhibitors—for example, Captopril and
Enalapril—are common medications used to treat
women with cardiac and endocrine symptoms in
thalassaemia (Noori and Keshavarz, 2015). These
drugs are not recommended during any stage of
pregnancy as they have caused or are suspected
of causing irreversible fetal damage (Morton and
Hague, 2015). Hydroxycarbamide (hydroxyurea)
is a cytotoxic drug successfully used to reduce
the need for blood transfusion by improving Hb
levels and erythropoiesis in individuals diagnosed
specifically with thalassaemia major; however,
it is not recommended for use with pregnant
women owing to known teratogenic effects (de
Dreuzy et al, 2016).