WORLD SICKLE CELL DISEASE DAY – 19 JUNE 2014

Royal College of Obstetricians and Gynecologists release:
New guideline for managing Thalassaemia in pregnancy announced at the RCOG World Congress in India

New advice for clinicians on the management of women with Thalassaemia in pregnancy, a condition that affects more than 70,000 babies worldwide each year, was published on 28 March 2014 by the Royal College of Obstetricians and Gynecologists (RCOG) at the annual RCOG World Congress in Hyderabad, India.

While globally there are around 100 million individuals who are carriers, it is most common among communities with Mediterranean and Asian origins. There are an estimated 1,000 individuals affected by thalassaemia in the UK, with the Indian, Pakistani and Bangladeshi communities accounting for 79% of all thalassaemia births.

This first edition guideline looks at how to best manage pregnant women with beta thalassaemia major, the more severe form of the condition which requires regular blood transfusions each year, and the milder form beta thalassaemia intermedia.

The complications of thalassaemia are also associated with an increased risk to both mother and baby during pregnancy, with a higher risk of maternal cardiomyopathy and diabetes as well as foetal growth restriction. Most women with thalassaemia will also require ovulation induction therapy to achieve pregnancy.

The new guidelines stress the importance of a multi-disciplinary healthcare team, emphasising that women with thalassaemia should be assessed by a cardiologist or haematologist prior to and throughout their pregnancy to ensure maintenance of haemoglobin and to plan the pregnancy accordingly.

The guideline stresses that iron chelation therapy is complex and should be tailored for treatment of the condition during pregnancy, it is also recommended that blood transfusions should continue on a regular basis for women with beta thalassaemia major. For women with beta thalassaemia intermedia transfusions should be considered if there are signs of worsening anaemia or foetal growth restriction.

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