Pregnancy in patients with hemoglobinopathies: 30-year results of a Greek Thalassemia and Sickle Cell Department

Sophia Delicou 1 , Konstantinos Manganas 1 , Panos Antsaklis 2 , Vasilios Pergialiotis 2 , Marianna Theodora 2 , Aikaterini Xydaki 1 , Michael Sindos 2 , Dimitrios Loutradis 2  and George Daskalakis 2
  • 1 Thalassemia and Sickle Cell Department, Hippocratio General Hospital Athens, Athens, Greece
  • 2 Division of Maternal-Fetal Medicine, 1 Department of Obstetrics and Gynecology, National and Kapodistrian University of Athens, Alexandra General Hospital Athens, Athens, Greece
Sophia Delicou
  • Thalassemia and Sickle Cell Department, Hippocratio General Hospital Athens, Athens, Greece
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, Konstantinos Manganas
  • Thalassemia and Sickle Cell Department, Hippocratio General Hospital Athens, Athens, Greece
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, Panos Antsaklis
  • Division of Maternal-Fetal Medicine, 1st Department of Obstetrics and Gynecology, National and Kapodistrian University of Athens, Alexandra General Hospital Athens, Athens, Greece
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, Vasilios Pergialiotis
  • Division of Maternal-Fetal Medicine, 1st Department of Obstetrics and Gynecology, National and Kapodistrian University of Athens, Alexandra General Hospital Athens, Athens, Greece
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, Marianna Theodora
  • Division of Maternal-Fetal Medicine, 1st Department of Obstetrics and Gynecology, National and Kapodistrian University of Athens, Alexandra General Hospital Athens, Athens, Greece
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, Aikaterini Xydaki
  • Thalassemia and Sickle Cell Department, Hippocratio General Hospital Athens, Athens, Greece
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, Michael Sindos
  • Division of Maternal-Fetal Medicine, 1st Department of Obstetrics and Gynecology, National and Kapodistrian University of Athens, Alexandra General Hospital Athens, Athens, Greece
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, Dimitrios Loutradis
  • Division of Maternal-Fetal Medicine, 1st Department of Obstetrics and Gynecology, National and Kapodistrian University of Athens, Alexandra General Hospital Athens, Athens, Greece
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and George Daskalakis
  • Corresponding author
  • Division of Maternal-Fetal Medicine, 1st Department of Obstetrics and Gynecology, National and Kapodistrian University of Athens, Alexandra General Hospital Athens, Athens, Greece
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Abstract

Background

The aim of the current study is the longitudinal epidemiological study of pregnancies, their outcome and the changes in their treatment, in patients with hemoglobinopathies, during 30 years at a Thalassemia and Sickle Cell Department.

Methods

The data of a total of 47 pregnancies of 40 women with hemoglobinopathies monitored in the Thalassemia and Sickle Cell Department of Hippokrateio General Hospital of Athens were retrospectively collected. The data were divided and evaluated in two time periods, the first before 2000 and the second between 2000 and 2017.

Results

There were four miscarriages and 43 completed pregnancies. The mean pregnancy duration was 34.92 weeks. Thalassemia major and thalassemia intermedia patients had higher percentages of in vitro fertilization (IVF) pregnancies and IVF attempts, with the majority of IVF attempts and pregnancies in the time period after 2000. During the period 2000–2017, more women received transfusions and iron chelation therapy both before and during pregnancy compared to the period before 2000. During the period 2000–2017, three women presented hemorrhagic complications. Placental abruption occurred in two cases, while one woman suffered a stroke. Six women had liver disease and two cardiac problems.

Conclusion

The rate of pregnancies in women with hemoglobinopathies has increased after the year 2000 due to the increased use of IVF technique. Pregnancy planning, close collaboration between gynecologists and hematologists and appropriate pregnancy monitoring are essential for an optimal pregnancy outcome.

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