Thalassemia And Pregnancy

[yeti]

My gf being pregnant we went to Samitivej Sukhumvit for a 1st visit. Doctor recommended a blood check which came back few days later: she has an abnormal RBC morphology, which means she may be an alpha thalassemia carrier. Doctor told us the only way to be sure is another blood check, an expensive one. But she said that we should better check my blood, because if I don't have any sign of thalassemia, then no need to worry, as only if both parent are affected it's a (potentially big) problem for the baby. My blood test came back as normal, no need to worry.

Then today we went to Sukumvit hospital, because I think Samitivej is too expensive. Bringed my gf test result (not mine as I only had the result over the phone). Doctor had a look at it, gave her medicine to prevent anemia, but did not ask me to do any blood test, or did not ask my gf for the expensive test.

So which one got it wrong? Samitivej doctor over prescribed as they are known to do, or Sukumvit doctor missed something really important, which would mean we'll forget about him?

[Orion76]

The severe or deadly forms of thalassemia are only inherited if both parents are carriers.

Thalassemia is very rare among white people. A doctor might assume you don't have it if you are white and be right 99.99% of the times, another doctor might like to do some tests to confirm.

[bina]

not white, caucasian... middle easterners have this gene too...

[Farma]

My daughter has Alpha Thalassemia Trait. It took many years and visits to doctors for it to be diagnosed.

If you haven't read up on it check this link. http://www.thalassemia.org/sections.php?sec=1

[yeti]

Thxs for the website address, quite informative. I notably found this:

Thalassemia was originally believed to be common only to people of the Mediterranean region, such as Italians, Greeks and Turks. (An early name for thalassemia major, or Cooley's anemia, was Mediterranean anemia).

I don't believe the second doctor could have known wether I'm Italian or not.

I also read that alpha thalassemia trait (which is what my gf may have) can be mistaken for iron deficiency, and the second doctor gave iron pills to my gf, maybe he made a different diagnosis. Which would still be weird as it was written on the Complete Blood Count we gave him tnot to rule out alpha thalassemia".

Anyway still don't know which hospital to chose .

[Orion76]

I also read that alpha thalassemia trait (which is what my gf may have) can be mistaken for iron deficiency, and the second doctor gave iron pills to my gf, maybe he made a different diagnosis. Which would still be weird as it was written on the Complete Blood Count we gave him tnot to rule out alpha thalassemia".

I'm not a doctor but AFAIK people with thalassemia should not be given iron supplements.

In any case iron levels should be checked before giving someone with anemia iron supplements. If the anemia is not caused by iron deficiency then taking supplements can cause a toxic build up of iron levels.

[macduff]

I also read that alpha thalassemia trait (which is what my gf may have) can be mistaken for iron deficiency, and the second doctor gave iron pills to my gf, maybe he made a different diagnosis. Which would still be weird as it was written on the Complete Blood Count we gave him tnot to rule out alpha thalassemia".

I'm not a doctor but AFAIK people with thalassemia should not be given iron supplements.

In any case iron levels should be checked before giving someone with anemia iron supplements. If the anemia is not caused by iron deficiency then taking supplements can cause a toxic build up of iron levels.

My wife has thalassemia which is very common in south east asia. According to the hematologist here in england traces of this problem are also found in irish people too. Which was a concern for me because i'm from irish desent. Luckly for me i've been given the all clear. My wife is midway between the major and the minor, and is being treated with folic acid tablets,and had been taking them throughout her pregnancy and now my son is born will still be taking them.In our case she had to have blood transfusions every month from when we arrived in feb until the birth at the end of june this was due to her blood count continuing to drop so they monitored her constantly every week at the anti natal clinic. Up to now my boy is fine but they are in the process of taking blood samples within the next few weeks to make sure he too is not anemic.

[Sheryl]

The treatment you received at Samitivej was correct. The treatment at the second hospital was negligent to say the very least.

Far from trying to rip you off, the Samitivej doctor was accomodating and creative in finding a way to exclude the most serious concern (transmission of thalassemia to your baby) without the expensive test.

Whether you stay with Samitivej or not is up to you but I would definitely recommend against the second hospital. If cost is a major concern and assuming it is a normal pregnancy with no unusual complications, you might want to consider Phayathai 2 Hospital (near Victory onument).

Regarding the iron, that is routine for pregnant women and as your girlfirend has only the alpha trait, should not present a problem.

[yeti]

Thxs all for your answers which will help me to make a final decision.

[Sheryl]

P.S. Also look at Saint Louis hospital. Non-profit with very reasonable costs. (Again, assuming no unusual problems requiring other than a regular ob-gyn).

[yeti]

Well, given the traffic in Bkk, I'd prefer an hospital nearby home (living near On Nut station).

We may end up in Samitivej Srinakarin, which is surprisingly a lot cheaper than Samitivej Sukhumvit (have to check how long it takes to go there).