The reproductive thalassemic population is growing older and doctors
confront the challenge of the thalassemic pregnancy. Pregnancy is
characterized by dynamic multiple system changes, resulting in increased
basal oxygen consumption, changes in energy substrate use by different
organs and increased susceptibility to oxidative stress, while
homozygous transfusion-dependent beta-thalassemia (beta-thal) patients
manifest cardiac, hepatic, endocrine, and metabolic disorders
attributable to chronic anoxia and iron overload. Pregnant thalassemic
patients require significantly larger amount of total blood transfusion
during pregnancy and iron overload increases the oxidative stress of
pregnancy, while the risk for cardiovascular events, in a high cardiac
output state, is augmented and chelation treatment is generally avoided
due to the potential teratogenicity. Pregnancy in thalassemia major
should be considered high risk, and be cared for by an expert team with
special caution and sensitivity
