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Blood Diseases and Pregnancy

Sickle Cell Disease and Thalassemia

By Jennifer Lacey

For many years, women who suffered from chronic diseases were persuaded by their physicians not to pursue becoming pregnant. This was especially true for women afflicted with two rare blood disorders: sickle cell disease and thalassemia.

However, because of advances in medicine and technology and proper prenatal care, the chances for these women to have a healthy pregnancy and delivery are slowly becoming a reality.

"Sickle cell disease and thalassemia are very different disorders," says Dr. Kenneth R. Bridges, associate professor of medicine at Harvard Medical School. "Both diseases affect red blood cells, but they manifest themselves differently. Each condition has two abnormal genes, but beyond that they have little in common."

To understand a diagnosis of sickle cell anemia or thalassemia, you have to learn about the origins of each disease. Hemoglobin, the oxygen-carrying element of red blood cells, helps your tissues and vital organs receive oxygen. Hemoglobin contains two distinct proteins: alpha and beta.

Thalassemia is diagnosed when a person's body fails to create enough of either of the two proteins. In essence, the red blood cells don't form properly and cannot carry the oxygen through the blood.

There are two categories of thalassemia: alpha thalassemia and beta thalassemia. According to the Cooley's Anemia Foundation in Flushing, N.Y., there are four different types of alpha thalassemia, which can range from mild to severe.

Thalassemia is commonly found and diagnosed in people of Italian, Greek, Middle Eastern and Asian descent. The major forms of treatment for people with thalassemia are regular blood transfusions.

"Blood transfusions help the person live, but produce another problem, namely iron overload," says Dr. Bridges. "Each unit of blood gives the patient the equivalent (in iron) to what a normal person would take in by mouth in six months. Excess iron is ultimately fatal, and patients must chronically take a medication called Desferal (deferoxamine) to remove the iron."

Want to see more?

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• Pregnant and Diabetic: How Will Diabetes Affect Your Pregnancy?
• Bowels and Babies: The Effects of Chronic Bowel Disease on Pregnancy
• Talk about it!

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