Current perspectives of fertility and pregnancy in thalassemia.
Current perspectives of fertility and pregnancy in thalassemia.
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DOI：
10.3109/03630260903365023
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发表时间：
2009-01-01
期刊：
影响因子：
1
通讯作者：
Chatterjee, Ratna
中科院分区：
文献类型：
--
作者：
Bajoria, Rekha;Chatterjee, Ratna
对于患有地中海贫血综合征的成年人来说，期望拥有一个家庭是改善生活质量的重要愿望。自然生育可以发生在良好螯合和输血的患者中，但大多数由于低促性腺激素性性腺功能减退症（HH）而无法生育，并且需要辅助生殖技术（ART）。我们报告了 11 名重型地中海贫血女性接受 ART 后怀孕的经历，这些女性患有 HH，卵巢功能完整。只有在多学科环境下进行孕前评估后，才能通过 ART 成功怀孕。十四名健康的新生儿已出生。 73% 进行了选择性剖腹产。怀有2对双胞胎，1对三胞胎。没有遇到明显的心脏并发症。早产和生长受限的发生率比背景人群高 3 倍。在所有情况下都鼓励母乳喂养。总之，对于患有 ss 地中海贫血且静息心脏功能正常且铁超负荷情况在多学科团队领导下的专家中心得到优化的女性来说，妊娠是可行且安全的。
Expectation to have a family is an important aspiration for a better quality of life for the adults with thalassaemia syndrome. Spontaneous fertility can occur in well chelated and transfused patients but majority are infertile due to hypogonadotrophic hypogonadism (HH) and need assisted reproductive techniques (ART). We report our experience of pregnancy following ART in 11 women with ss-thalassaemia major, who had HH with functionally intact ovaries. Pregnancy was achieved successfully by ART only after pre-pregnancy assessment in a multidisciplinary setting. Fourteen healthy newborn infants were delivered. Elective caesarean section was performed in 73%. There were 2 sets of twins and one set of triplet pregnancy. No significant cardiac complications were encountered. The incidence of preterm labour and growth restriction were 3 fold higher than the background population. Breast feeding was encouraged in all cases. In conclusion, pregnancy is feasible and safe in women with ss-thalassemia with normal resting cardiac performance and optimised iron overload in specialist centres under a multi disciplinary team.