How to test for thalassemia during pregnancy

After pregnancy, every expectant mother has to go through rounds of blood draws. Some are to pass the blood for various screenings, and many are to check whether there is anemia during pregnancy or other blood diseases. The following tests for thalassemia during pregnancy are some of the necessary tests during pregnancy. Let’s follow the editor to learn more about them.

Thalassemia (abbreviated as thalassemia) is the most common incomplete dominant chronic hemolytic anemia in the population. Its pathogenesis is the reduction or absence of globin chains that synthesize hemoglobin.

Loss of this protein leads to abnormal hemoglobin structure. Red blood cells with abnormal hemoglobin have reduced deformability and shortened lifespan. They can be destroyed prematurely by the liver, spleen, etc. of the human body, leading to anemia and even developmental abnormalities. This disease is medically known as hemolytic anemia.

12 weeks of pregnancy, routine blood test

If you have just become pregnant, it is normal to find anemia in your first blood test.

Many expectant mothers lose blood due to menstruation before pregnancy, resulting in insufficient body storage after pregnancy; and the development of the placenta and fetus requires an increase in blood volume, so the iron supply must be twice that before pregnancy; plus the decrease in stomach acid after pregnancy also affects the absorption of iron in the diet, and after pregnancy, the mother is unable to take in enough iron through the diet. All of the above factors make pregnant women prone to "iron deficiency anemia".

Iron deficiency anemia

Iron deficiency anemia is the most common anemia during pregnancy. Some expectant mothers experience it in the early stages of pregnancy, and it is even worse in the 5th to 6th month of pregnancy.

If the iron deficiency continues to worsen, it will affect the production of red blood cells and lead to anemia and insufficient blood oxygen supply, causing symptoms such as fatigue, dizziness, shortness of breath, pale complexion, lack of physical strength, reduced exercise endurance and decreased immunity.

Note: Generally speaking, non-pregnant women need about 15 mg of iron per day, and pregnant mothers need about 27 mg of iron per day. However, if the pregnant mother has low hemoglobin, is pregnant with twins or multiple babies, and does not supplement iron regularly during pregnancy, her daily iron requirement should be increased to 60-100 mg.

In terms of the entire pregnancy period, the iron demand is relatively low in the first four months of pregnancy, and no additional supplement is needed during this period, as it may aggravate nausea and vomiting in pregnant women. After four months of pregnancy, the recommended daily supplement is 27-30 mg.

12 weeks of pregnancy, thalassemia test

Thalassemia is a blood disease caused by a genetic defect that results in the lack of hemoglobin synthesis. It is also called thalassemia and can be divided into type A and type B.

【Thalassemia】

Type A: Termination of pregnancy is recommended. If a pregnant woman suffers from type 1 thalassemia, in severe cases she may develop preeclampsia, eclampsia, or placenta previa, which may cause heavy bleeding before or after delivery. As for the fetus in the womb, it will cause severe hemolysis, anemia and tissue hypoxia.

At around 20 weeks, the fetus will have hepatosplenomegaly, pleural effusion and edema, which may lead to fetal death in the late pregnancy, or death shortly after birth due to poor lung development and severe anemia and hypoxia. Therefore, doctors will often recommend termination of pregnancy.

Type B: The fetus will have no abnormalities. If a pregnant woman suffers from type B thalassemia, the fetus will not have any abnormalities in the mother's body. It is usually not until the baby is 6 months old and shows symptoms such as maldevelopment and anemia that it will be diagnosed by a doctor.

Children with type 2 thalassemia usually need long-term blood transfusions to stay alive. Although bone marrow transplantation and umbilical cord blood stem cell treatments are currently available, the cost is high and the success rate is only about 50%.

According to statistics, the proportion of pregnant women suffering from thalassemia is 1/300-1/500. The most feared situation of this disease is that both husband and wife have the same type of thalassemia, because there is a 1/4 chance of fetal stillbirth or severe anemia after birth, requiring long-term blood transfusions.

ABO hemolysis

Expectant mothers should check their blood type before delivery, understand the fetal condition as early as possible, and prepare various monitoring measures for neonatal hemolytic disease as early as possible. In addition, the antibody titer should also be measured in pregnant women with type O blood.

The examination time is: the first time is at 16 weeks of pregnancy, the second time is at 28-30 weeks of pregnancy, and then follow-up is once every 2-4 weeks.

Note: Ultrasound examination can also help detect fetal hemolysis. When the fetus is found to have skin edema, pleural and abdominal effusion, hepatosplenomegaly, and enlarged placenta, the possibility of maternal-fetal blood type incompatibility should be considered.

There is currently no cure for thalassemia. To prevent this disease, pregnant women and their spouses should undergo premarital examinations and prenatal genetic diagnosis to avoid giving birth to the next generation of children with thalassemia.

The editor reminds everyone that thalassemia is mainly prevented. Mild thalassemia does not require treatment. Severe thalassemia requires hematopoietic stem cell transplantation. Without hematopoietic stem cell transplantation, patients can only rely on blood transfusions and long-term use of

Iron removal agents are used to maintain life, so women should be responsible for themselves and their babies and should undergo a Mediterranean screening test before pregnancy.