Hb is reducing in beta thalassemia minor patient who is pregnant. Why?

Question

Hi doctor,

My wife is pregnant with twins, 24 weeks now. Her hemoglobin levels never in her life had gone above 10. At the start of pregnancy, it was 8.5 but now it has touched 7.7. We did a serum ferritin test, and her level was 50 (normal) which I guess means no iron deficiency. She is a beta thalassemia minor as per the detailed reports. Can you please guide me here? Our gynecologist would be consulting a hematologist today but if we can get an opinion here it would be great.

Thanks.

Answer 1

Hi,

Welcome to icliniq.com.

I read your query and understand your concern.

Thalassemia minor is hemoglobinopathy and so the hemoglobin level can never be above 12 in such a patient. In pregnancy, plasma is increased and so hemodilution can lead to more fall in hemoglobin levels in CBC. Orofer XT like an Iron tablet can be prescribed for such cases. It would be great if the Hb level remains around 9 or 10 during pregnancy. The Iron infusion can be given in the second or third trimester of pregnancy only if needed. You can discuss all these with your treating doctor or hematologist. No other mode of treatment is available as per my opinion. Close watch-up is necessary in such cases. I would like to suggest you investigate HB electrophoresis as well to avoid thalassemia, major child.

Thank you for consulting me.

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