IRON OVERLOAD, CARDIAC AND OTHER FACTORS AFFECTING PREGNANCY IN THALASSEMIA MAJOR
IRON OVERLOAD, CARDIAC AND OTHER FACTORS AFFECTING PREGNANCY IN THALASSEMIA MAJOR
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DOI：
10.3109/03630269.2010.485004
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发表时间：
2010-01-01
期刊：
影响因子：
1
通讯作者：
Aessopos, Athanasios
中科院分区：
文献类型：
--
作者：
Tsironi, Maria;Karagiorga, Markissia;Aessopos, Athanasios
地中海贫血的生殖人群日益老龄化，医生面临着地中海贫血妊娠的挑战。妊娠期的特点是多系统动态变化，导致基础耗氧量增加、不同器官对能量底物利用的变化以及对氧化应激的易感性增加，而纯合子输血依赖性β-地中海贫血（β-thal）患者则因慢性缺氧和铁超载而出现心脏、肝脏、内分泌和代谢紊乱。妊娠期地中海贫血患者在妊娠期需要大量输血，铁超负荷会增加妊娠期氧化应激，而在高心输出量状态下，心血管事件的风险会增加，由于潜在的致畸性，通常避免螯合治疗。重型地中海贫血的妊娠应被视为高风险，并由专家团队特别谨慎和敏感地进行护理。
The reproductive thalassemic population is growing older and doctors confront the challenge of the thalassemic pregnancy. Pregnancy is characterized by dynamic multiple system changes, resulting in increased basal oxygen consumption, changes in energy substrate use by different organs and increased susceptibility to oxidative stress, while homozygous transfusion-dependent beta-thalassemia (beta-thal) patients manifest cardiac, hepatic, endocrine, and metabolic disorders attributable to chronic anoxia and iron overload. Pregnant thalassemic patients require significantly larger amount of total blood transfusion during pregnancy and iron overload increases the oxidative stress of pregnancy, while the risk for cardiovascular events, in a high cardiac output state, is augmented and chelation treatment is generally avoided due to the potential teratogenicity. Pregnancy in thalassemia major should be considered high risk, and be cared for by an expert team with special caution and sensitivity.