Key points
l The management of women diagnosed with thalassaemia is complex,
requiring a multidisciplinary approach to care, as the potential for
maternal and fetal complications present risks during pregnancy
and birth
l The major risks for maternal complications stem from organ damage
caused by excessive iron stores deposited in target organs and
surrounding tissue; osteoporosis, diabetes mellitus, hypothyroidism
and a reduced efficiency of endocrine glands
l Anaemia during pregnancy is an obstetric risk amplified by
thalassaemia, with many women previously asymptomatic needing
transfusions to maintain therapeutic Hb levels
l Fetal Hb Barts hydrops fetalis is a rare thalassaemia mutation that
can occur during pregnancy, causing extreme haemoglobin instability,
severe anaemia and hypoxia to the fetus
l Pharmacological treatment is the first line of therapy in managing
symptoms of thalassaemia, and research into complementary and
alternative medicine suggests that non-pharmacological therapies
may provide cost-effective, low-risk support to pregnant women