Division of Hematology/Oncology, Hospital of the University of Pennsylvania, Perelman School of Medicine, 3400 Civic Center Boulevard, Philadelphia, PA 19104, USA.
Division of Hematology/Oncology, UCSF Benioff Children's Hospital, 747 52nd Street, Oakland, CA 94609, USA.
Hematol Oncol Clin North Am. 2023 Apr;37(2):393-411. doi: 10.1016/j.hoc.2022.12.008.
Because women with transfusion-dependent thalassemia are seeking pregnancy, ensuring the best outcomes for both mother and baby require concerted and collaborative efforts between the hematologist, obstetrician, cardiologist, hepatologist, and genetic counselor among others. Proactive counseling, early fertility evaluation, optimal management of iron overload and organ function, and application of advances in reproductive technology and prenatal screening are important in ensuring a healthy outcome. Many unanswered questions remain requiring further study, including fertility preservation, non-invasive prenatal diagnosis, chelation therapy during pregnancy, and indications and duration of anticoagulation.
由于患有输血依赖型地中海贫血症的女性正在寻求怀孕,因此需要血液学家、产科医生、心脏病专家、肝病专家和遗传咨询师等共同努力,以确保母婴的最佳结局。积极主动的咨询、早期生育能力评估、铁过载和器官功能的最佳管理,以及生殖技术和产前筛查的应用,对于确保健康的结果都非常重要。仍有许多悬而未决的问题需要进一步研究,包括生育力保存、非侵入性产前诊断、妊娠期间的螯合疗法,以及抗凝的指征和持续时间。