Medical disorders in pregnancyFree in the app
Thalassaemia and sickle cell
Thalassaemia trait is common in Pakistan — test the partner.
Source: BSH 2024 · RCOG GTG 61, 66Thalassaemia trait (carrier)
- Low MCV and MCH with normal or high ferritin: do Hb electrophoresis or HPLC.
- If she is a carrier, test the partner straight away.
- Both carriers: offer prenatal diagnosis (CVS from 11 weeks) early.
- Do not give iron unless ferritin is low.
- Folic acid 5 mg daily.
Thalassaemia major
- Keep pre-transfusion Hb above 100 g/L.
- Before pregnancy: cardiac T2* above 20 ms, liver iron below 7 mg/g.
- Stop oral chelators 3 months before conception.
- Aspirin if splenectomised or platelets above 600; LMWH too if both.
Sickle cell disease
- Folic acid 5 mg, aspirin from 12 weeks, penicillin V, vitamin D.
- LMWH from 28 weeks (earlier with extra risks), every admission, and 6 weeks after birth.
- Growth scans every 4 weeks from 24 weeks; birth at 38–40 weeks.
- Labour: keep SpO2 94% or more, avoid pethidine, continuous CTG.
- Crisis: analgesia within 30 minutes.
A summary for trained clinicians. Always check the full guideline, the patient in front of you and your hospital's protocol. Spotted an error? Tell us.