beta-thalassemia major and successful pregnancy

OBJECTIVE: To conduct a study of maternal and fetal outcome in pregnant women with transfusion-dependent beta-thalassemia major. STUDY DESIGN: The course and outcome of pregnancy were studied prospectively in 32 pregnant women with transfusion-dependent beta-thalassemia major, of which 10 were HIV 1 positive, at Sanjay Gandhi Hospital, Manipur, India, from January 1990 to July 1996. RESULTS: Over a period of six years, 32 women with transfusion-dependent beta-thalassemia major conceived. Twenty conceptions were spontaneous (63%), and 12 (37%) followed induction of ovulation. There were 24 (75%) singleton vaginal deliveries, all of which were term. At term, eight (25%) women delivered by elective cesarean section due to cephalopelvic disproportion. All the women remained well throughout pregnancy. Despite increased blood transfusion requirements during pregnancy to maintain the hemoglobin level > 10 g/dL, serum ferritin levels remained stable in all patients. CONCLUSION: Successful outcomes of pregnancy occurred in some women with transfusion-dependent beta-thalassemia major.