Short

Diseritropoietic hemolytic anemia and pregnancy

Diseritropoietic hemolytic anemia and pregnancy

Question:

- I am 32 years old and suffer from dyseritropoietic hemolytic anemia. I have been diagnosed with this condition since 4 years. The condition is congenital, the mother having the same diagnosis. My question is this: what risks can there be if I want a child during pregnancy and especially, what risks could the child be exposed to? I know that during the period of hemolysis I have low Hb 5-7%, but I would like to become a mother. What advice do you give me? Thank you very much!

Answer:

You specified the critical level reached by Hb in times of crisis, but did not provide details regarding the possible degree of co-infection of other organs such as the liver, spleen, heart, kidneys in order to give a more detailed answer. based on the information I can tell you the following:

You specified the critical level reached by Hb in times of crisis, but did not provide details regarding the possible degree of co-infection of other organs such as the liver, spleen, heart, kidneys in order to give a more detailed answer. based on the information I can tell you the following:

  • regarding the possibility of hereditary transmission, a genetic consultation is necessary that can offer you the desired clarifications;
  • regarding the impact on the product of conception, in a well-monitored pregnancy it may be completely absent or if it can be minimal and treated (if in severe anemia, with hemoglobin values ​​below 6 g / dl, cases with acute fetal suffering have been registered and intrauterine death of the fetus, in the forms of mild and medium anemia, there is an increase in the frequency of prematurity - the baby is born before term -, abortion and neonatal mortality)
  • regarding the impact on your state of health - the answer is dependent on the presence or absence of other co-effects or complications.
  • Also, depending on the hemoglobin level, the manifestations may be different. Thus, at Hb values ​​below 6 g / dl, high heart failure may occur. For Hb values ​​between 6 and 11 g / dl, it was found that the most frequent association with preeclampsia and eclampsia, placental abnormalities (praevia placenta, premature insertion of normal inserted placenta) - at these the major risk being bleeding, various labor dystocia, Increased postpartum incidence of hemorrhagic and infectious complications.
    Knowing that pregnancy involves a number of adaptive reactions for the woman's body, including increased blood volume, which results in anemia, which may aggravate anemia of the type you suffer from or highlight various other types of anemia.
    I mention that all this is possible, but any change can be prevented, and the forms of evolution differ from case to case. When the patient has a full prenatal consultation and is properly monitored throughout the pregnancy, she is properly assisted during labor, these changes may be missing.