There are 25 per cent chances that two thalassemia traits will give birth to a thalassemia major. On this World Thalassemia Day (May 8), we focus on the importance of getting thalassemia test before marriage and the complications associated during family planning.

It was a difficult phase for the 29 year old lady who came to Moolchand Hospital recently. She was a Thalassemia minor carrier and had lost 7 foetuses due to miscarriages. She had a pale skin and had to undergo regular intrauterine blood transfusion. It was after all this that she delivered a baby boy. She admits that it was her mistake of not undergoing a thalassemia test before wedding.

More than 10,000 babies are born with thalassemia in India and live on regular blood transfusion throughout their life. The only curative measure is bone marrow transplant which is difficult to match. Consultant, Women’s and Child Institute, Dr Yukti Yuvakshi Juneja from Moolchand Medcity said, “Thalassemia is an inherited blood disorder that reduces the amount of hemoglobin in the body and leads to the destruction of red blood cells. A person can only get thalassemia trait or disease by inheriting the genes from their parent.”

Complications

Dr Yukti added, “The problem arises when two people with thalassemia minor disorder marry each other. In such cases, there are 25 percent chances of having a baby with thalassemia major which is dependent on regular blood transfusion throughout their life to survive as their body does not make haemoglobin which is needed to make red blood cells.”
If a partner is thalassemia minor, then there is no issue as he/ she can lead a normal healthy life with only pale skin or anaemia. It is important to get a test done before marriage to rule out the chances of any complications during family planning. Talking about the risks, Dr Ravindra Gupta, Internal Medicine from Columbia Asia Hospital said, “Even a minor injury can cause severe bleeding. Also thalasseamics may become more prone to infections. One more thing which many people are not aware of is the increased risk of bleeding in thalassemia major patients.

Precautions

Women considering pregnancy with thalassemia traits should keep the following points in consideration:

• Those considering pregnancy should be assessed for risks to the mother and foetus of thalassemia traits.
• Expecting mothers should consult the prenatal diagnosis facility for thalassemia diagnosis. If a thalassemia major foetus is identified, the couple is advised to terminate the pregnancy.
• Detailed assessment and management prior to pregnancy and close monitoring of the health of the mother and foetus during and after pregnancy should be ensured.
• During pregnancy, women should be managed by an obstetrician with knowledge of thalassemia-associated risks and a cardiologist.
• “Every thalassemia minor patient should take supplement oral folic acid tablets regularly,” added Dr Yukti

Better safe than sorry

A couple has to undergo a simple blood test before marriage. A test named amniocentesis should be done within 12 months of the pregnancy to detect if the child is affected or not. This test helps in prenatal diagnose of any abnormalities in the chromosomes.

“If both parents are thalassaemic they should go for genetic counselling and chorionic villous sampling and amniocentesis and decide accordingly as advised by experts,” said Dr Uma Rani from Asian Hospital.

Myths busted

Due to lack of knowledge, people have many misconceptions about thalassemia. Dr Uma Rani helps busts some common myths about this ailment:

• I’m not sick and neither is my partner, so our children can’t inherit a disorder
• We are both carriers, so we have a 1 in 4 chance of having a child with the disorder. If I have four children, one of them will be sick
• The other people in my family will be fine. I don’t need to let them know that I’m a carrier
• My child is only a carrier, so it’s not something we need to talk about.
• Only women need to be screened as they carry children and pass the disease.
• You can catch sickle cell or thalassaemia from infected blood, like HIV or hepatitis