Bajoria Rekha, Chatterjee Ratna
Department of Obstetrics and Gynaecology, Institute for Women's Health, University College London and University College Hospital, London, UK.
Hemoglobin. 2009;33 Suppl 1:S131-5. doi: 10.3109/03630260903365023.
Expectation to have a family is an important aspiration for a better quality of life for the adults with thalassaemia syndrome. Spontaneous fertility can occur in well chelated and transfused patients but majority are infertile due to hypogonadotrophic hypogonadism (HH) and need assisted reproductive techniques (ART). We report our experience of pregnancy following ART in 11 women with ss-thalassaemia major, who had HH with functionally intact ovaries. Pregnancy was achieved successfully by ART only after pre-pregnancy assessment in a multidisciplinary setting. Fourteen healthy newborn infants were delivered. Elective caesarean section was performed in 73%. There were 2 sets of twins and one set of triplet pregnancy. No significant cardiac complications were encountered. The incidence of preterm labour and growth restriction were 3 fold higher than the background population. Breast feeding was encouraged in all cases. In conclusion, pregnancy is feasible and safe in women with ss-thalassemia with normal resting cardiac performance and optimised iron overload in specialist centres under a multi disciplinary team.
组建家庭的期望是地中海贫血综合征成年患者追求更高生活质量的一项重要愿望。螯合和输血状况良好的患者可能会自然受孕，但大多数患者因低促性腺激素性性腺功能减退（HH）而不孕，需要辅助生殖技术（ART）。我们报告了11例重型β地中海贫血女性患者在接受ART后怀孕的经验，这些患者患有HH且卵巢功能完好。仅在多学科环境下进行孕前评估后，通过ART成功实现了妊娠。共分娩出14名健康新生儿。73%的产妇接受了选择性剖宫产。有2例双胎妊娠和1例三胎妊娠。未出现明显的心脏并发症。早产和生长受限的发生率比一般人群高3倍。所有病例均鼓励母乳喂养。总之，在专科中心，由多学科团队管理，对于静息心脏功能正常且铁过载得到优化的重型β地中海贫血女性患者，怀孕是可行且安全的。
