Crismanto Layarta, Arief Prijatna, Ratna Widyastuti

DOI: https://doi.org/10.23917/biomedika.v11i1.7843


Thalassemia (including one type of haemoglobinopathies) is the most common genetic disease in the world. Pregnancy with thalassemia major is at risks of fetal hypoxia, intrauterine growth restriction, and prematurity as twice as normal pregnancy. We report a case of pregnancy, 28-years-old pregnant woman, in poorly treated thalassemia major patient. She came to obstetric outpatient clinic for the first antenatal care. Her gestational age was 19-20 weeks. She was diagnosed with thalassemia major previously, with poorly treated. She was pale and her spleen was enlarged with Schuffner score amounted to four. Her face showed Cooley facies which is specified in thalassemia patient. Her initial hemoglobin level was 2.2 g/dL with hypochromic microcytic erythrocyte. Thereafter, she underwent 4 series of packed red cell transfusion until delivery. The electrocardiography showed left ventricular hypertrophy with global ischemia. The pregnancy was terminated by elective caesarean section by indication of cephalopelvic disproportion. There was no intrapartum and postpartum complication in this patient. Her baby was 2,800 grams and 47 cm in length. Hereinafter, no abnormalities were found in neonatal examination. This case emphasizes the importance of establishing a diagnosis and the optimal treatment op of thalassemia major during pregnancy. Collaboration of obstetrician, cardiologist, hematologist, and neonatologist is needed to attain favorable pregnancy outcome in thalassemia major pregnant patients.

Keywords: Thalassemia Major, Pregnancy, Outcome


Aessopos, A., Karabatsos, F., Farmakis, D., Katsantoni, A., Hatziliami, A., Youssef, J., Karagiorga, M. 1999. Pregnancy in patients with well- treated beta-thalassaemia: outcome for mothers and newborn infants. Am J Obstet Gynecol. 180: 360–365.

Cappellini, M.D., Cohen, A., Porter, J., Taher, A., and Viprakasit, V.2014. Guidelines for the Management of Transfusion Dependent Thalassemia. Cyprus: Thalassemia International Foundation.

Daskalakis, G.J., Papageorgiou, I.S., Antsaklis, A.J., Michalas, S.K. 1998. Pregnancy and homozygous beta thalassemia major. Br J Obstet Gynaecol.105:1028- 1032

Figueiredo, A.C.M.G., Gomes-Filho, I.S., Silva, R.B., Pereira, P.P.S., Mata, F.A.F.D., Lyrio, A.O., Souza, E.S., Cruz, S.S., and Pereira, M.G. 2018. Maternal Anemia and Low Birth Weight: A Systematic Review and Meta-Analysis. Nutrients 2018, 10, 601 pp.1-17

Galanello R & Origa F, 2010. Beta Thalassemia. Galanello and Origa Orphanet Journal of Rare Diseases 2010, 5:11 pp.1-15

Goldenberg MM, 2011. Pharmaceutical Approval Update. P&T Vol. 36 No. 12

Kyei-Mensah AAA, 2014. Management of Beta Thalassemia in Pregnancy. Green Top Guideline no. 66. Royal College of Obstetricians and Gynecologists pp.8-11

Leung, T.Y. and Lao, T.T., 2012. Thalassemia in pregnancy. Best Practice & Research Clinical Obstetrics and Gynaecology 26 (2012) 37–51

Levy, A., Fraser, D., Katz, M., Mazor, M., Sheiner, E. 2005. Maternal anemia during pregnancy is an independent risk factor for low birthweight and preterm delivery. Eur J Obstet Gynecol Reprod Biol. 122:182–186.

Modell, B., and Darlison, M., 2008. Global epidemiology of haemoglobin disorders and derived service indicators. Diakses http://www.who.int/bulletin/volumes/86 /6/06-036673/en/ tanggal 8 April 2018 pukul 13.00

National Institute of Health: National Center for Advancing Translational Sciences, 2015. Thalassemia. Diambil dari: https://rarediseases.info.nih.gov/diseases /7756/thalassemia. Amerika Serikat.

Perkumpulan Dokter Spesialis Penyakit Dalam Indonesia, 2015. Sindrom Talasemia dalam: Penatalaksanaan di Bidang Ilmu Penyakit Dalam: Panduan Klinik Praktis. Jakarta: InternaPublishing, p. 491-493

Petrikos G, Andriopoulos P, Tsironi M. 2016. Pregnancy in women with tahalassemia: challenges and solutions. International Journal of Women’s Health 2016:8 441–451

Singer ST & Vichinsky EP, 1999. Deferoxamine Treatment during Pregnancy: Is It Harmful?. American Journal of Hematology 60:24–26

Traisrisilp K, Luewan S, Tongsong T. 2009. Pregnancy outcomes inwomen complicated by thalassemia syndrome at Maharaja Nakorn Chiang Mai Hospital. Arch Gynecol Obstet. 279:685– 689.

U.S. National Library of Medicine, 2018. Thalassemia. Diambil dari: https://medlineplus.gov/ency/article/000587.htm. Amerika Serikat.

Wanapirak, C., Muninthorn, W., Sanguansermsri, T., Dhananjayanonda, P., Tongsong, T. 2004. Prevalence of thalassemia in pregnant women at Maharaj Nakorn Chiang Mai Hospital. J Med Assoc Thai. Dec;87(12):1415-8

Zafari M & Kosaryan M, 2014. Marriage and child bearing in patients with transfusion-dependent thalassemia. J. Obstet. Gynaecol. Res. Vol. 40, No. 8: 1978–1982

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