Thalassemia Screening Premarital Postmarital and Pregnancy

Who all should get thalassemia screening?

Thalassemia screening should become a policy under law for one and all. However, some stages of life certainly require the testing to be done. Following below category of peolple are required to take thalassemia screening:

Premarital:
If you are still single and are planning to get married, get your blood tests for thalassemia first because keep in mind that two negatives always make a positive. So if your spouse is also a thalassemia minor with you as well, there is a strong possibility that your child could be born with thalassemia major.

Postmarital:
Its never too late, but if you are aware. Before planning for your child you should get your as well as your spouse's blood tested.

Pregnancy:
Though the complications are high in gestational conditions, still precaution is better than cure.

Prenatal:
With the test mentioned in the section of prenatal testing, it is better to ensure yourself that your baby is perfectly fine.

Neonates:

New borns should also get tested to judge if they have thalassemia and if it is there, certain precautionary steps could be taken.

Can women with thalassemia have healthy pregnancies?
Women with thalassemia who require blood transfusions often have a higher rate of infertility. However, some women with the disorder are able to become pregnant. For sake of baby's health, chelating drugs are usually stopped during pregnancy. There is a chance that these drugs could pose risks to the baby. As long as a woman cares for few things, it is quite sure that she would have a normal pregnancy. There are few complications that could intrude in a healthy gestational period in the thalassemia victim, be it minor or major. We will see them one by one:

Pregnancy in Thalassemia minor individuals:
Women with milder forms of thalassemia usually have healthy pregnancies. Trait status is generally thought not to cause health problems, although some women with Beta thalassemia trait may have an increased tendency toward anemia during pregnancy. The stress factor observed during pregnancy worsens the thalassemic trait.

Pregnancy in Thalassemia major individuals:
Until recently, pregnancy was rare in women with beta thalassemia major. Several recent studies suggest that pregnancy appears safe for a woman with well-treated beta thalassemia major who does not have heart problems. Some of the following risks may arise during the pregnancy of a thalassemia major female:
The heart and liver are most vulnerable organs during pregnancy, as is the endocrine system, which secretes hormones in the body. Each of these systems must be closely monitored before and throughout pregnancy.
During pregnancy, the volume of blood in the mother's body rises substantially. The higher volume of blood in the mother's body also adds to the amount of work that the heart has to perform. Therefore, women with thalassemia need to have their heart function checked before they become pregnant. During pregnancy, they may need to have regular blood transfusions to lessen the amount of stress on the heart.
Thalassemic patients have an increased risk of developing type 1 diabetes. Thus, diabetes needs to be well controlled before and throughout pregnancy.

What should we eat in thalassemia?
Dietary Recommendations: Nutritional deficiencies are common in thalassemia. This might be due to hemolytic anemia, increased nutritional requirements, iron overload, diabetes and chelator use. Patients should get them evaluated for albumin, 25-hydroxy vitamin D, fasting glucose, fasting plasma zinc, serum copper, ceruloplasmin, serum selenium, alpha and gamma tocopherol, plasma ascorbate and serum folate and a proper diet chart on adequate dietary intake of calcium, Vitamin D folate, trace minerals (copper, zinc and selenium) and antioxidant (vitamin E) should be asked from the physician. Certain important dietary substances are there which are recommended in particular. Listed below are few of them:
Folic acid is an important nutritional requirement through the early weeks of normal pregnancy and the same is true for thalassemic patients. Folic acid not only helps in preventing neural tube defects in the developing baby, it also helps to reduce the mother's risk of developing a special type of anemia called megaloblastic anemia.
Typically multivitamin supplementation without iron is suggested (e.g., Centrum Silver in tablet or chewable form is now available).
Drinking black tea with meals is recommended to reduce iron absorption from food.
Vitamin D supplementation (50,000 IU once a week until levels normalize) is recommended for patients with a 25-hydroxy vitamin Dless than 20 ng/dL.
Calcium supplementation should be encouraged if dietary intake is insufficient.

How can I improve my thalassemia?

Management is the another issue that is to be taken care with enormous patience. Anyone who is a thalassemic needs a lot of emotional and physical support. They should be handled with great love and care:

Avoid excess iron: Unless your doctor recommends it, don't take vitamins or other supplements that contain iron.

Eat a healthy diet: Eating a balanced diet that contains plenty of nutritious foods can help you feel better and boost your energy. Your doctor may also recommend you take a folic acid supplement to help your body make new red blood cells. Also, to keep your bones healthy, make sure your diet contains adequate calcium and vitamin D. Ask your doctor what the right amounts are for you, and whether you need to take a supplement.

Avoid infections: Protect yourself from infections with frequent hand-washing and by maintaining safe distance from people who are ill. This is especially important if you've had to have your spleen removed.

You'll also need an annual flu shot, as well as the meningitis, pneumococcal and hepatitis B vaccines to prevent infections. If you develop a fever or other signs and symptoms of an infection, see your doctor for treatment.

How do you manage beta thalassemia?

Management of thalassemia requires below points to be kept in mind:
Correction of anaemia with repeated blood transfusions
Removal of iron overload
Treatments of complications
Correction of hemopoiesis with bone marrow transplant
Prevention of the disease by antenatal diagnosis and genetic counseling
Pharmacological methods to increase gamma chain synthesis
Gene replacement therapy

5 Questions to ask in thalassemia

It is your foremost duty to be aware of your health and also your genetic history. If there is a case in your close intimates, you are supposed to ask few questions to your specialist:
1. What's the most likely cause of my or my child's symptoms?
2. What kinds of blood tests and treatments are needed?
3. What are the most common side effects from each treatment?
4. How can they best be managed?
5. Are there any dietary restrictions to follow or a need to take any nutritional supplements?