Thalassemia Screening in Pregnant Women at Antenatal Care Clinic Srinagarind Hospital

Abstract

Background  and  Objective : Thalassemia is one of  the important problems disease in Thailand . The cost of therapy is high.  Major thalassemia diseases  are  Hb Bart’s  hydropsfetalis ,  β-thalassemia  homozygous and  β-thalassemia / Hb E diseases.  The Ministry of Public Health set up the National Thalassemia Act in 2007 – 2011 .  The prenatal screening of major thalassemia diseases to reduce new cases is one of the policy.  Health care providers have to set up the standard system to prevention , control and treatment according to the policy.  Antenatal care clinic,  Srinagarind  Hospital has developed service system to have husband of pregnant women  who are carrier or disease come for thalassemia screening in order to find out the couple at risk for major thalassemia disease. The objective is to study the result of thalassemia screening in pregnant women at Srinagarind Hospital.

Study design  : Retrospective  descriptive study

Setting  : Antenatal care clinic , Srinagarind  Hospital , Faculty of Medicine , Khon Kaen  University .

Subjects  : Thalassemia screened pregnant women first presenting at antenatal care clinic, Srinagarind Hospital from 1 Junuary 2007 to 31 December 2010.

Method  : The ethics committee approved the study in humans.  Medical records of thalassemia screened pregnant women in antenatal care clinic and genetic counselling clinic at Srinagarind Hospital between January 2007 to December 2010 were analysed and presented.  Thalassemia screeing results of pregnant women and husbands were analysed .

Result  : All 2,704 new cases of pregnant women had undergone thalassemia screening  (100%).  2,704 Pregnant women ( 61.5% ) were less than or  equal  12 weeks gestation.  917 of 2,704 cases (33.91 %) had abnormal screening test. Following at service system , 883 husbands of 917  cases ( 96.29 % ) were notified and came to hospital for thalassemia blood checking.  46 Couples at risk for major thalassemia  (1.7 %) were identified,  23 couples at risk ( 0.85% ) for Hb Bart’s hydrops fetalis , 23 couples at risk (0.85 %) for β-thalassemia / Hb E disease.  After DNA analysis , only 10 pregnant women underwent prenatal diagnosis and found only 2 fetuses who had severe major thalassemia deseases.  Both of pregnant women choosed termination of pregnancy.

Conclusion  : Antenatal care clinic Srinagarind Hospital has service system to prevent and control of thalassemia disease. Out  system accomplish the goal of the National thalassemia Act  2007 – 2012 by screening all new cases  of pregnant women who came to antenatal care clinic ,  set up the system to have husband of  these pregnant women who are carrier or disease come back to have thalassemia blood  checking together  with at prenatal counselling and diagnosis system.

Key wards : Thalassemia screening , Pregnant  women