Severe Thalassemia Syndrome Screening in Pregnant Women at Maharat Nakhon Ratchasima Hospital

Abstract

Objectives. To study the percentage of positive thalassemia screening test in pregnant woman and husband and to find out the couple at risk of having severe thalassemia syndrome fetus (especially B-thalassemia homozygous and 00-thalassemia homozygous). Design. Prospective descriptive study Setting. Department of Obstetrics and Gynecology, Maharat Nakhon Ratchasima Hospital Methods. Two thousands and nineteen pregnant  women who came to antenatal clinic at Maharat Nakhon Ratchasima Hospital during July 1999 to December 1999 were screened for thalassemic carriers by using the Thal Screen Test (osmotic fragility test, OF) as screening test and polymerase chain reaction (PCR), HbA₂ level for diagnostic test for couples whom the result of screening were positive to find out the couple at risk of having severe thalassemia syndrome fetus. Result. The positive screening test of thalassemia in pregnant women was 18.5% (373/2,019 cases). Among these 373 women 241 (64.6%) husband turned up for blood examined and 50 of 241 (20.7%) had positive screening test. Only 5 Couples (5/50 couples, 10.0%) were found to be risk of having sever thalassemia. syndrome fetus, two couples having risk of 00-thalassemia homozygous, three couples of B-thal/Hb E. In this study we did not found any couple having risk of B-thalassemia homozygous. Conclusion. The prevalence of the couple at risk of having severe thalassemia syndrome fetus (especially B-thalassemia homozygous and 00-thalassemia homozygous Nakhon Ratchasima Hospital was only 2:2,019 of pregnant women (0.1%), whose 64.6% of husbands were screened. We suggested an effective clinical practice guildeline in thalssemia screening that would be practically used in general hospitals.